Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 2018012016 | MO |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 2018012016 | MO |
NPI | 1972899862 |
---|---|
Provider Name | Jennifer Bickhaus |
First Address | Saint Louis, MO 63117-1856 |
Second Address | Saint Louis, MO 63117-1856 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2011 |
Last Update Date | 10/02/2021 |