Provider Demographics
NPI:1083262950
Name:GERBER, JEAN MARY (RD)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:MARY
Last Name:GERBER
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Gender:F
Credentials:RD
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Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:CB 8031
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-286-2069
Mailing Address - Fax:314-286-2085
Practice Address - Street 1:8 MILLSTONE CAMPUS DR
Practice Address - Street 2:STE 2000
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-5766
Practice Address - Country:US
Practice Address - Phone:314-286-2069
Practice Address - Fax:314-286-2085
Is Sole Proprietor?:No
Enumeration Date:2019-09-03
Last Update Date:2019-10-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2001007896133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered