Individual
JODI JANY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
3 SAINT ELIZABETH BLVD STE 3800, O FALLON, IL 62269-1281
(618) 234-2120
(618) 222-4636
Mailing address
PO BOX 22407, SAINT LOUIS, MO 63126-0407
(636) 386-7222
(636) 200-4036
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209020922
IL
363LG0600X
Gerontology Nurse Practitioner
2016006912
MO
Other
Enumeration date
03/03/2016
Last updated
05/12/2020
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