Renitra Jackson is a Family in Saint Louis, Missouri. Renitra Jackson practices all healthcare services and medical treatments related to Family. The NPI Number for Renitra Jackson is 1144399270. The last update date is 2023-03-08.
Renitra Jackson's current location address is 5503 Delmar Blvd Ste B, Saint Louis, Missouri. You can contact this provider via phone number 8447767200. The mailing address for Renitra Jackson is 5503 Delmar Blvd Ste B, Saint Louis, Missouri. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Renitra Jackson |
|---|---|
| Address | 5503 Delmar Blvd Ste B, Saint Louis, Missouri |
| Phone Number | 8447767200 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | FNP |
NPI Number Detail
| NPI Number | 1144399270 |
|---|---|
| Provider Enumeration Date | 2006-11-06 |
| Last Updated Date | 2023-03-08 |
Provider Mailing Address Detail
| Address | 5503 Delmar Blvd Ste B |
|---|---|
| City | Saint Louis |
| State | Missouri (MO) |
| Post Code | 631123122 |
| Phone Number | 8447767200 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Family |
|---|---|
| Taxonomy | 363Lf0000X |
| Licence No | 2000164715 |
|
Definition: An advanced practice registered nurse expert in primary healthcare for patients of all ages. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1144399270 | MO | -- | |
| 1144399270 | IL | -- |
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What is the unique 10-digit identifier code assigned to Renitra Jackson by the Centers for Medicare & Medicaid Services?
The Renitra Jackson has been issued the NPI (National Provider Identifier) 1144399270 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Where is the Renitra Jackson located?
The Renitra Jackson is located at 5503 Delmar Blvd Ste B, Saint Louis, MO 631123122.
What is Renitra Jackson's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Renitra Jackson is Family, and the taxonomy classification code that categorizes this area of expertise is 363Lf0000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1144399270 to Renitra Jackson?
The Centers for Medicare & Medicaid Services originally issued the 1144399270 to Renitra Jackson on 2006-11-06.
When was the information related to Renitra Jackson most recently updated or refreshed?
The details pertaining to the Renitra Jackson, including its address, specialty, and other relevant information, were last updated or refreshed on 2023-03-08.
NPI Number: 1902809924
Address: 2400 W Main St, Rock Hill, SC