Jesenick, Crystal S
Jesenick, Crystal S is an individual health care provider with primary practice located at 922 Talon Dr Suite B, O Fallon IL 62269-1848. 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. Jesenick, Crystal S can be contacted via phone (618) 972-5641.Contact Information
Primary practice address
922 Talon Dr Suite B
O Fallon IL 62269-1848
Phone: (618) 972-5641
Fax: (314) 270-5283
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | 209006003 | Illinois |
Profile Details
| NPI number | 1396831616 |
|---|---|
| LBN Legal business name | Jesenick, Crystal S |
| Credentials | A.N.P.-C |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 5th, 2006 |
| Last updated | Oct 16th, 2015 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396831616 | NPPES |
| Missouri | MEDICAID | 427014204 |
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