Provider Demographics
NPI:1033426523
Name:QUINN, JENNIFER SUSANNE
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SUSANNE
Last Name:QUINN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9200 EDDIE AND PARK RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63126-2810
Mailing Address - Country:US
Mailing Address - Phone:314-752-2692
Mailing Address - Fax:
Practice Address - Street 1:9200 EDDIE AND PARK RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63126-2810
Practice Address - Country:US
Practice Address - Phone:314-752-2692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-07
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula