Provider Demographics
NPI:1831209840
Name:AYERS, JEANNINE (ANP)
Entity type:Individual
Prefix:
First Name:JEANNINE
Middle Name:
Last Name:AYERS
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:670 MASON RIDGE CENTER DR
Mailing Address - Street 2:STE 300
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8573
Mailing Address - Country:US
Mailing Address - Phone:636-344-2400
Mailing Address - Fax:636-344-2401
Practice Address - Street 1:20 PROGRESS POINT PKWY
Practice Address - Street 2:STE 108
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-2206
Practice Address - Country:US
Practice Address - Phone:636-344-2400
Practice Address - Fax:636-344-2401
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2015-11-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO080031363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health