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General NPI Number Information
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NPI Number | 1902830151
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Entity Type | Individual
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Provider Name | JUDITH MARIE JEGLIJEWSKI APRN, BC, MS, CDE
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Gender | Female
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 04/08/2014
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Provider Practice Location Address
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Address Line | 222 S WOODS MILL RD SUITE 410N
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City | CHESTERFIELD
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State | MO
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Zip | 63017-3625
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Country | US
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Telephone | 314-469-6224
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Fax | 314-469-0744
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Provider Business Mailing Address
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Address Line | 294 VILLAGE MEAD DR
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City | BALLWIN
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State | MO
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Zip | 63021-6129
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Country | US
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Telephone | 314-469-6224
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Fax | 314-469-0744
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN201534
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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License Number | RN046407
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 124987-21
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License Number State | MO
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