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General NPI Number Information
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NPI Number | 1952898348
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Entity Type | Individual
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Provider Name | JESSICA M LEVIN NP-C
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Gender | Female
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Dates
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Enumeration Date | 04/20/2018
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 70 JUNGERMANN CIR STE 201
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City | SAINT PETERS
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State | MO
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Zip | 63376-1619
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Country | US
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Telephone | 636-916-9615
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Fax | 314-653-4149
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Provider Business Mailing Address
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Address Line | 70 JUNGERMANN CIR STE 201
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City | SAINT PETERS
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State | MO
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Zip | 63376-1619
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Country | US
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Telephone | 636-916-9615
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Fax | 314-653-4149
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2017037840
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License Number State | MO
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