Provider Demographics
NPI:1578748299
Name:NESKE, CYNTHIA J (WHNP)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:J
Last Name:NESKE
Suffix:
Gender:F
Credentials:WHNP
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Mailing Address - Street 1:621 S NEW BALLAS RD
Mailing Address - Street 2:SUITE 499A
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8232
Mailing Address - Country:US
Mailing Address - Phone:314-251-7477
Mailing Address - Fax:314-251-7476
Practice Address - Street 1:621 S NEW BALLAS RD
Practice Address - Street 2:SUITE 499A
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8232
Practice Address - Country:US
Practice Address - Phone:314-251-7477
Practice Address - Fax:314-251-7476
Is Sole Proprietor?:No
Enumeration Date:2007-12-31
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO128515363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1578748299Medicaid
MO1578748299Medicaid