Provider Demographics
NPI:1568151116
Name:JAEGERS, SALMA HASSAN
Entity Type:Individual
Prefix:
First Name:SALMA
Middle Name:HASSAN
Last Name:JAEGERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12082 COUNTY ROAD 4001
Mailing Address - Street 2:
Mailing Address - City:HOLTS SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:65043-2538
Mailing Address - Country:US
Mailing Address - Phone:573-301-6066
Mailing Address - Fax:
Practice Address - Street 1:705 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65101-2941
Practice Address - Country:US
Practice Address - Phone:573-301-6066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide