Provider Demographics
NPI:1336746569
Name:GILTNER, JENNIFER SHARON (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:SHARON
Last Name:GILTNER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1826 RUSSELL BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-3443
Mailing Address - Country:US
Mailing Address - Phone:573-480-0771
Mailing Address - Fax:
Practice Address - Street 1:15945 CLAYTON RD STE 330
Practice Address - Street 2:
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63011-2492
Practice Address - Country:US
Practice Address - Phone:573-480-0771
Practice Address - Fax:636-256-5396
Is Sole Proprietor?:No
Enumeration Date:2020-10-01
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020029124363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily