Provider Demographics
NPI:1205032893
Name:HORST, JENNIFER ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ANNE
Last Name:HORST
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 505570
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63150-5570
Mailing Address - Country:US
Mailing Address - Phone:314-862-4050
Mailing Address - Fax:314-862-1141
Practice Address - Street 1:8888 LADUE RD
Practice Address - Street 2:STE 100
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63124-2326
Practice Address - Country:US
Practice Address - Phone:314-862-4050
Practice Address - Fax:314-862-1141
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2024-04-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO20090316502080P0204X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200032826Medicaid