Provider Demographics
NPI:1093081507
Name:OKEEFE, JANICE ANN (RD,LD)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:ANN
Last Name:OKEEFE
Suffix:
Gender:F
Credentials:RD,LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3833 MONSOLS DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63034-2441
Mailing Address - Country:US
Mailing Address - Phone:314-344-6373
Mailing Address - Fax:314-344-6936
Practice Address - Street 1:12303 DEPAUL DR.
Practice Address - Street 2:
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63044-2588
Practice Address - Country:US
Practice Address - Phone:314-344-6373
Practice Address - Fax:314-344-6936
Is Sole Proprietor?:No
Enumeration Date:2012-03-29
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001021475133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered