Healthcare Provider Details

I. General information

NPI: 1942277249
Provider Name (Legal Business Name): E J ESKEW MS APRN BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANAE J ESKEW MS APRN BC

II. Dates (important events)

Enumeration Date: 03/06/2006
Last Update Date: 05/03/2022
Certification Date: 05/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2685 EAST MAIN STE A
JACKSON MO
63755
US

IV. Provider business mailing address

2685 EAST MAIN STE A
JACKSON MO
63755
US

V. Phone/Fax

Practice location:
  • Phone: 573-204-1400
  • Fax: 573-204-1480
Mailing address:
  • Phone: 573-204-1400
  • Fax: 573-204-1480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number130641
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: