Active NPI
Jessica Dusablon, RN
- Registered Nurse
- Saint Peters, MO
National Provider Identifier
1093540650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 2020027300
- Practice address
- 321 Knaust Rd
Saint Peters, MO 63376-1715 - Phone
- (636) 441-6465
- NPI assigned
- Sep 4, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 2020027300 | MO | Primary |
Addresses
Primary practice location
321 Knaust Rd
Saint Peters, MO 63376-1715
Mailing address
796 Del Vista CT
Villa Ridge, MO 63089-1806
Phone (314) 971-8192
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020027300 | MO | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725408000000",
"number": "1093540650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "796 DEL VISTA CT",
"city": "VILLA RIDGE",
"state": "MO",
"postal_code": "630891806",
"telephone_number": "314-971-8192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "321 KNAUST RD",
"city": "SAINT PETERS",
"state": "MO",
"postal_code": "633761715",
"telephone_number": "636-441-6465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUSABLON",
"first_name": "JESSICA",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-04",
"last_updated": "2024-09-04",
"certification_date": "2024-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MO",
"license": "2020027300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Peters, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.