JENNIFER SOUTHWARD

FENTON, MO
NPI1790100089
Former NameJENNIFER OLDHAM
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LP0200X Nurse Practitioner, Pediatrics
(Licence: MO  2013037116)
Enumeration Date2014-02-24
Last Update Date2025-08-05
Business Address
JENNIFER SOUTHWARD CPNP
1203 SMIZER MILL RD
FENTON, MO 63026-3483
Phone number: 636-717-1350
Mailing Address
JENNIFER SOUTHWARD CPNP
12680 OLIVE BLVD
SAINT LOUIS, MO 63141-6289
Phone number: 314-529-5660