JENNIFER DIANE ROTH

CAPE GIRARDEAU, MO
NPI1477105427
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: MO  2019024741)
Additional Taxonomies363LG0600X Nurse Practitioner, Gerontology
(Licence: MO  2019024741)
Enumeration Date2019-07-10
Last Update Date2021-09-26
Business Address
JENNIFER DIANE ROTH FNP-C
1723 BROADWAY ST STE 315
CAPE GIRARDEAU, MO 63701-4556
Phone number: 573-519-4960
Mailing Address
JENNIFER DIANE ROTH FNP-C
525 OMETE CREEK LN
PERRYVILLE, MO 63775-6631
Phone number: