Provider Demographics
NPI:1609875376
Name:SHEW, JO ANN (RN)
Entity Type:Individual
Prefix:
First Name:JO ANN
Middle Name:
Last Name:SHEW
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:5000 CEDAR PLAZA PARKWAY
Mailing Address - Street 2:STE 350
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-3441
Mailing Address - Country:US
Mailing Address - Phone:314-843-4333
Mailing Address - Fax:314-843-4856
Practice Address - Street 1:763 S NEW BALLAS RD
Practice Address - Street 2:SUITE 110
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8704
Practice Address - Country:US
Practice Address - Phone:314-569-1717
Practice Address - Fax:314-569-0441
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-15
Last Update Date:2010-03-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO056386364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOS04729Medicare UPIN