Jill Maureen Hauler

Individual provider Active NPI Licensed Practical Nurse · Webster Groves, MO

NPI 1962075770 · NPPES record last updated Jul 20, 2021

Key facts

NPI
1962075770
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
2011011325 (MO)
Practice address
723 S Laclede Station Rd
Webster Groves, MO 63119-4911
Phone
(314) 968-5570
NPI assigned
Jul 20, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2011011325MOMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 2011011325 MO Yes

Addresses

Primary practice location

723 S Laclede Station Rd
Webster Groves, MO 63119-4911

Mailing address

723 S Laclede Station Rd
Webster Groves, MO 63119-4911
Phone (314) 968-5570

Other providers in Webster Groves, MO

All providers in Webster Groves, MO · Licensed Practical Nurse in Missouri

Sources for this page

Verify at the official NPI Registry.