Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | MO2003011569 | MO |
NPI | 1578768602 |
---|---|
Provider Name | Dr. Wendi Lorraine Jones |
First Address | St Peters, MO 63376-8123 |
Second Address | St Charles, MO 63303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2007 |
Last Update Date | 03/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MO2003011569 | STATE LICENSE (01) | MO |