PRINCY JACOB (NPI# 1134766652) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134766652 |
| Entity Type | Individual |
| Full Name | PRINCY JACOB |
| Practice Address |
6420 Clayton Rd Richmond Heights MO 63117-1811 |
| Practice Telephone | 3147688722 |
| Mailing Telephone | 3147688722 |
| Enumeration Date | 2019-12-03 |
| Last Update Date | 2019-12-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WL0100X |
Registered Nurse Specialization: Lactation Consultant |
RN-84496 | NM | Nursing Service Providers |
| Street Address |
6420 CLAYTON RD |
| City | RICHMOND HEIGHTS |
| State | MO |
| Zip Code | 63117-1811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730780636 | Stephanie Dawn Seidenstricker | Registered Nurse | 6420 Clayton Rd, Richmond Heights, MO 63117-1811 | 2020-11-06 |
| 1508464801 | Leslie Agusti | Dietitian, Registered | 6420 Clayton Rd, Richmond Heights, MO 63117-1811 | 2020-10-09 |
| 1154958775 | Allison Elizabeth Watkins | Obstetrics & Gynecology | 6420 Clayton Rd, Richmond Heights, MO 63117-1811 | 2020-03-24 |
| 1588290464 | Allison Leigh Gustafson | Obstetrics & Gynecology | 6420 Clayton Rd, Richmond Heights, MO 63117-1811 | 2020-03-23 |
| 1467091561 | Rebecca Dubberke | Registered Nurse | 6420 Clayton Rd, Richmond Heights, MO 63117-1811 | 2020-01-06 |
| 1013555952 | Audrey Kate Dombrowski | Dietitian, Registered | 6420 Clayton Rd, Richmond Heights, MO 63117-1811 | 2019-12-10 |
| 1477103182 | Rebecca Boedeker | Registered Nurse | 6420 Clayton Rd, Richmond Heights, MO 63117-1811 | 2019-09-14 |
| 1801441928 | Leah Marie Brandmeyer | Physician Assistant | 6420 Clayton Rd, Richmond Heights, MO 63117-1811 | 2019-08-06 |
| 1942855366 | Cep America LLC | Emergency Medicine | 6420 Clayton Rd, Richmond Heights, MO 63117-1811 | 2019-08-02 |
| 1346894144 | Phan Thuc Hang | Nurse Practitioner | 6420 Clayton Rd, Richmond Heights, MO 63117-1811 | 2019-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255956611 | Efehi Kelly Ogbomo | Student in an Organized Health Care Education/Training Program | 6420 Clayton Rd, Suite 2218, St. Louis, MO 63117 | 2020-06-11 |
| 1619533890 | Abdul Rauf | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road. Ssm Health St. Mary's Hospital, St. Louis, MO 63117 | 2019-05-14 |
| 1083278477 | Mohamed Maali Gumaa Mohamed | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road Ssm St. Mary's Hospital, Department of Internal Medicine, St. Louis, MO 63117 | 2019-05-01 |
| 1750945556 | Samrat Jun Jayanth | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm Health St Mary's Hospital, St. Louis, MO 63117 | 2019-04-26 |
| 1215491329 | Latonya Allen | Counselor | 1612 S. Big Bend Blvd, St. Louis, MO 63117 | 2019-01-23 |
| 1265917025 | Blue Stars Therapy, LLC | Occupational Therapist | 1101 Edward Terrace, Apt A, St. Louis, MO 63117 | 2018-09-27 |
| 1770060014 | Ultra Care Home Services LLC | Home Health | 7353 Dale Ave, Saint Louis, MO 63117 | 2018-07-19 |
| 1235623562 | Melissa Valerie Taylor | Counselor | Psychological Services of St Louis, LLC, 7110 Oakland Ave, St Louis, MO 63117 | 2018-06-20 |
| 1124517289 | Jideofor Ebony Obodozie | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm St. Mary's Hospital, St. Louis, MO 63117 | 2018-05-04 |
| 1770071706 | Sivaram Prabhuji Muppaneni | Student in an Organized Health Care Education/Training Program | Ssm St Mary's Hospital, 6420 Clayton Road, St. Louis, MO 63117 | 2018-04-25 |
| Find all providers in zip 63117 | ||||
| Taxonomy Code | 163WL0100X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Lactation Consultant |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467091561 | Rebecca Dubberke | Registered Nurse | 6420 Clayton Rd, Richmond Heights, MO 63117-1811 | 2020-01-06 |
| 1477103182 | Rebecca Boedeker | Registered Nurse | 6420 Clayton Rd, Richmond Heights, MO 63117-1811 | 2019-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285260133 | Morgan Jackson | Registered Nurse | 504 Bellefontaine Ave Apt 1, Kansas City, MO 64124-1960 | 2020-03-22 |
| 1790337657 | Allie Jade Heffington | Registered Nurse | 3539 S Lone Pine Ave # 200, Springfield, MO 65804-4854 | 2019-07-11 |
| 1801352612 | Rachel C Snider | Registered Nurse | 1710 Jennings Pl, Chillicothe, MO 64601-1960 | 2019-02-17 |
| 1972087989 | Amanda Stoops | Registered Nurse | 2805 Middlebush Dr, Columbia, MO 65203-1559 | 2018-09-17 |
| 1093298655 | Melissa Marie Jackson | Registered Nurse | 456 W 68th St, Kansas City, MO 64113-1919 | 2018-09-10 |
| 1740791490 | Emily Miller | Registered Nurse | 13315 Donnelly Ave, Grandview, MO 64030-3544 | 2017-10-21 |
| 1306363676 | Kathleen Blaha | Registered Nurse | 3413 Riverchase Pkwy, Saint Charles, MO 63301-4113 | 2017-08-27 |
| 1295256279 | Nicole Halling | Registered Nurse | 12320 Se State Route A, Saint Joseph, MO 64507-7413 | 2017-06-29 |
| 1972964153 | Terry L Vogt | Registered Nurse | 6437 Murdoch Ave, Saint Louis, MO 63109-2605 | 2016-03-15 |
| 1376918953 | Melissa Ann Liebhart | Registered Nurse | 3948 Summerview Dr, Saint Charles, MO 63304-2661 | 2015-12-07 |
| Find all providers with the same taxonomy | ||||
| City | RICHMOND HEIGHTS |
| Zip Code | 63117 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.