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1275249237
ANTIONETTE JORDAN
SAINT LOUIS, MO
NPI
1275249237
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: MO 2022047351)
Enumeration Date
2023-01-24
Last Update Date
2023-08-06
Business Address
ANTIONETTE JORDAN
10004 KENNERLY RD STE 374B
SAINT LOUIS, MO 63128-2178
Phone number: 314-842-9669
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Mailing Address
ANTIONETTE JORDAN
PO BOX 802841
KANSAS CITY, MO 64180-2841
Phone number: 314-842-9669
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