Provider Demographics
NPI:1982083267
Name:GERKEN, JENNIFER E (DC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:E
Last Name:GERKEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 MAY VALLEY DR APT F
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63026-3893
Mailing Address - Country:US
Mailing Address - Phone:314-239-0333
Mailing Address - Fax:
Practice Address - Street 1:519 MAY VALLEY DR APT F
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MO
Practice Address - Zip Code:63026-3893
Practice Address - Country:US
Practice Address - Phone:314-239-0333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-20
Last Update Date:2025-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020038136111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor