Provider Demographics
NPI:1427891654
Name:KALINOWSKY, JESSICA ANN (RN, BSN, IBCLC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANN
Last Name:KALINOWSKY
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:453 PARKGATE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63367-4384
Mailing Address - Country:US
Mailing Address - Phone:314-503-3953
Mailing Address - Fax:
Practice Address - Street 1:453 PARKGATE DR
Practice Address - Street 2:
Practice Address - City:LAKE SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63367-4384
Practice Address - Country:US
Practice Address - Phone:314-503-3953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-15
Last Update Date:2025-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009004901163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant