Individual
MS. JAYERRA WHITLEY ENOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6464 TIDE WATER DR, FLORISSANT, MO 63033-4939
(314) 313-4533
Mailing address
6464 TIDE WATER DR, FLORISSANT, MO 63033-4939
(314) 313-4533
Taxonomy
Speciality
Code
Description
License number
State
364SL0600X
Long-Term Care Clinical Nurse Specialist
14103
MO
3747P1801X
Personal Care Attendant
14103
MO
376K00000X
Nurse's Aide
Primary
14103
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
342810997
NURSING
MO
Enumeration date
12/11/2024
Last updated
12/11/2024
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