Diekhoff, Jessica H

Diekhoff, Jessica H is an individual health care provider with primary practice located at 12855 N Forty Dr Ste 280, St. Louis MO 63141. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Diekhoff, Jessica H can be contacted via phone (314) 432-4415.

Contact Information

Primary practice address
12855 N Forty Dr Ste 280 St. Louis MO 63141
Phone: (314) 432-4415
Fax: (314) 432-1986
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 140356 Missouri

Profile Details

NPI number 1164662276
LBN Legal business name Diekhoff, Jessica H
Credentials APRN, BC
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 2nd, 2009
Last updated Jul 15th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164662276 NPPES
Missouri Other P01134602 RAILROAD MEDICARE
Missouri MEDICAID 1164662276 RAILROAD MEDICARE
Missouri Other P22480 RAILROAD MEDICARE

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