Provider Demographics
NPI:1114404811
Name:FRENCH, JENNIFER TERESA (A-GNP-C)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:TERESA
Last Name:FRENCH
Suffix:
Gender:F
Credentials:A-GNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1265 GRAHAM RD STE 1
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63031-8018
Mailing Address - Country:US
Mailing Address - Phone:314-741-1600
Mailing Address - Fax:314-741-1677
Practice Address - Street 1:1400 US HIGHWAY 61 STE 240A
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-4141
Practice Address - Country:US
Practice Address - Phone:636-937-3337
Practice Address - Fax:636-931-7671
Is Sole Proprietor?:No
Enumeration Date:2018-07-25
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018027117363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420057573Medicaid