Provider Demographics
NPI:1093456774
Name:KREKE, JORDYN LYNN FRANCES (MD)
Entity type:Individual
Prefix:DR
First Name:JORDYN
Middle Name:LYNN FRANCES
Last Name:KREKE
Suffix:
Gender:
Credentials:MD
Other - Prefix:DR
Other - First Name:JORDYN
Other - Middle Name:LYNN FRANCES
Other - Last Name:HUSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1465 S GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-1003
Mailing Address - Country:US
Mailing Address - Phone:314-577-5634
Mailing Address - Fax:
Practice Address - Street 1:1465 S GRAND BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-1003
Practice Address - Country:US
Practice Address - Phone:314-268-4070
Practice Address - Fax:314-268-4019
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program