Healthcare Provider Details

I. General information

NPI: 1811159882
Provider Name (Legal Business Name): JESSICA MUENSTERMAN DOWNS OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS JESSICA ANN MUENSTERMAN

II. Dates (important events)

Enumeration Date: 06/30/2008
Last Update Date: 06/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 EAGLE BLUFF HEIGHTS
WINFIELD MO
63389-3453
US

IV. Provider business mailing address

102 EAGLE BLUFF HEIGHTS
WINFIELD MO
63389-3453
US

V. Phone/Fax

Practice location:
  • Phone: 636-668-6171
  • Fax: 636-668-6355
Mailing address:
  • Phone: 636-668-6171
  • Fax: 636-668-6355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2008017063
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: