Provider Demographics
NPI:1659187292
Name:JEMERSON, MARCHELLI GENEVIEVE
Entity type:Individual
Prefix:
First Name:MARCHELLI
Middle Name:GENEVIEVE
Last Name:JEMERSON
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 1:3006 N LINDBERGH BLVD STE 709
Mailing Address - Street 2:
Mailing Address - City:SAINT ANN
Mailing Address - State:MO
Mailing Address - Zip Code:63074-3242
Mailing Address - Country:US
Mailing Address - Phone:314-739-4673
Mailing Address - Fax:314-739-4703
Practice Address - Street 1:3006 N LINDBERGH BLVD STE 709
Practice Address - Street 2:
Practice Address - City:SAINT ANN
Practice Address - State:MO
Practice Address - Zip Code:63074-3242
Practice Address - Country:US
Practice Address - Phone:314-739-4673
Practice Address - Fax:314-739-4703
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care