Provider Demographics
NPI:1386816130
Name:BRICKLER, JENNIFER (RN, MSN, NNP, BC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:BRICKLER
Suffix:
Gender:F
Credentials:RN, MSN, NNP, BC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:BUCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:7503 FINESTOWNE POINTE CT
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63129-6220
Mailing Address - Country:US
Mailing Address - Phone:314-293-1992
Mailing Address - Fax:
Practice Address - Street 1:1465 S GRAND BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-1003
Practice Address - Country:US
Practice Address - Phone:314-577-5631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-01
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO146825363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal