Healthcare Provider Details

I. General information

NPI: 1205032893
Provider Name (Legal Business Name): JENNIFER ANNE HORST MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 04/17/2025
Certification Date: 11/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8888 LADUE RD STE 100
SAINT LOUIS MO
63124-2326
US

IV. Provider business mailing address

PO BOX 7412125
CHICAGO IL
60674-2125
US

V. Phone/Fax

Practice location:
  • Phone: 314-862-4050
  • Fax: 314-862-1141
Mailing address:
  • Phone: 314-862-4050
  • Fax: 314-862-1141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2009031650
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number2009031650
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: