Provider Demographics
NPI:1164499000
Name:ARTER, JENNIFER LEA (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LEA
Last Name:ARTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:12360 MANCHESTER RD
Mailing Address - Street 2:STE 100
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-4302
Mailing Address - Country:US
Mailing Address - Phone:314-966-8500
Mailing Address - Fax:314-966-4499
Practice Address - Street 1:12360 MANCHESTER RD
Practice Address - Street 2:STE 100
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-4302
Practice Address - Country:US
Practice Address - Phone:314-966-8500
Practice Address - Fax:314-966-4499
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2021-11-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2001006089208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208783605Medicaid