Provider Demographics
NPI:1518506567
Name:SAMARGO, JENNIFER CATHERINE (CST, CSFA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:CATHERINE
Last Name:SAMARGO
Suffix:
Gender:F
Credentials:CST, CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 WHISPERING PINES DR APT D
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-4595
Mailing Address - Country:US
Mailing Address - Phone:314-682-9285
Mailing Address - Fax:
Practice Address - Street 1:1329 WHISPERING PINES DR APT D
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-4595
Practice Address - Country:US
Practice Address - Phone:314-682-9285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-22
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant