Provider Demographics
NPI:1609393966
Name:PYTLINSKI, JEANETTE STONEY (ACNP)
Entity type:Individual
Prefix:MS
First Name:JEANETTE
Middle Name:STONEY
Last Name:PYTLINSKI
Suffix:
Gender:
Credentials:ACNP
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-747-1206
Mailing Address - Fax:314-222-6252
Practice Address - Street 1:620 S TAYLOR AVE
Practice Address - Street 2:DIV IM INFECTIOUS DISEASE, STE 100
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1035
Practice Address - Country:US
Practice Address - Phone:314-747-1206
Practice Address - Fax:314-222-6252
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2017040103363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420051486Medicaid