Provider Demographics
NPI:1952047649
Name:STLOUIS, JENNY
Entity Type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:
Last Name:STLOUIS
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 1:83 GILMAN FALLS AVE
Mailing Address - Street 2:
Mailing Address - City:OLD TOWN
Mailing Address - State:ME
Mailing Address - Zip Code:04468-1316
Mailing Address - Country:US
Mailing Address - Phone:207-659-1039
Mailing Address - Fax:
Practice Address - Street 1:83 GILMAN FALLS AVE
Practice Address - Street 2:
Practice Address - City:OLD TOWN
Practice Address - State:ME
Practice Address - Zip Code:04468-1316
Practice Address - Country:US
Practice Address - Phone:207-659-1039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-06
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care