JACOB CRUST (NPI# 1508236555) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508236555 |
| Entity Type | Individual |
| Full Name | JACOB CRUST |
| Practice Address |
233 Clarkson Rd Ellisville MO 63011-2219 |
| Mailing Address |
1238 Oak Borough Dr Ballwin MO 63021-8337 |
| Practice Telephone | 6362568644 |
| Mailing Telephone | 5735296972 |
| Enumeration Date | 2015-10-02 |
| Last Update Date | 2015-10-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
2015035376 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
233 CLARKSON RD |
| City | ELLISVILLE |
| State | MO |
| Zip Code | 63011-2219 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417974080 | Jessee Crane | Family Medicine | 233 Clarkson Rd, Ellisville, MO 63011-2219 | 2006-07-17 |
| 1467092783 | Jesse Lee Lawson | Nurse Practitioner | 233 Clarkson Rd, Ellisville, MO 63011-2219 | 2020-01-15 |
| 1104338268 | Audrey Heath | Nurse Practitioner | 233 Clarkson Rd, Ellisville, MO 63011-2219 | 2017-10-30 |
| 1336650217 | Sharon Maureen Sweet | Nurse Practitioner | 233 Clarkson Rd, Ellisville, MO 63011-2219 | 2017-10-18 |
| 1639562028 | Anne Wolk | Nurse Practitioner | 233 Clarkson Rd, Ellisville, MO 63011-2219 | 2015-03-10 |
| 1538575063 | Sherry Lynn Clawson | Nurse Practitioner | 233 Clarkson Rd, Ellisville, MO 63011-2219 | 2014-07-04 |
| 1740626563 | Joan M Mccourt | Nurse Practitioner | 233 Clarkson Rd, Ellisville, MO 63011-2219 | 2013-05-20 |
| 1265771208 | Barbara E Pine | Nurse Practitioner | 233 Clarkson Rd, Ellisville, MO 63011-2219 | 2013-02-12 |
| 1033482195 | Lisa Munch | Nurse Practitioner | 233 Clarkson Rd, Ellisville, MO 63011-2219 | 2012-02-20 |
| 1457637811 | Dawn M Forbes | Nurse Practitioner | 233 Clarkson Rd, Ellisville, MO 63011-2219 | 2011-10-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205309234 | Heather Renee Leone | Nurse Practitioner | 452 Sovereign Court Suite A, Ballwin, MO 63011 | 2019-01-02 |
| 1538635297 | Jennifer Lea Nicole O'donnell | Registered Nurse | 13861 Manchester Road, Town and Country, MO 63011 | 2018-10-22 |
| 1285127712 | Genevieve Friedmann | Social Worker | 301 Sovereign Ct Ste 103, Ballwin, MO 63011 | 2018-06-09 |
| 1881187391 | Andrew Cittadino Link | Dentist | 14335 Manchester Road, Ballwin, MO 63011 | 2018-06-08 |
| 1972041283 | Anavan LLC | Durable Medical Equipment & Medical Supplies | 14390 Manchester Rd, Saint Louis, MO 63011 | 2017-02-07 |
| 1780131300 | Autism and Behavioral Spectrum LLC | Day Training, Developmentally Disabled Services | 14733 Clayton Road, Chesterfield, MO 63011 | 2016-09-01 |
| 1265872964 | Eryn Nichole Miner | Behavioral Analyst | 15834 Clayton Road, Ellisville, MO 63011 | 2013-06-27 |
| 1194168765 | Donna Margaret Carrillo | Developmental Therapist | 15834 Clayton Rd., Ellisville, MO 63011 | 2013-04-12 |
| 1891047486 | Ashley Amanda Battaglia | Chiropractor | 15945 Clayton Rd Ste 230c, Ballwin, MO 63011 | 2012-10-08 |
| 1750658480 | Gary Frank Sobocinski | Pharmacist | 4033 Sovereign Court, Ballwin, MO 63011 | 2011-11-23 |
| Find all providers in zip 63011 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205443165 | Mallory Stockstill | Nurse Practitioner | 27 Tillery Pl, Ellisville, MS 39437-4784 | 2020-09-24 |
| 1699389189 | Lindsay Ranae Pell | Nurse Practitioner | 305 Hill St, Ellisville, MS 39437-2521 | 2020-09-02 |
| 1851773865 | Mary Guion Brock | Nurse Practitioner | 124 Bonnybridge Ct, Ellisville, MO 63021-4507 | 2015-06-25 |
| 1326457151 | Lacey Blakeney | Nurse Practitioner | 1242 Highway 29 N, Ellisville, MS 39437-8763 | 2014-08-06 |
| 1053486852 | Natalia Angelia Stevenson | Nurse Practitioner | Ellisville State School, 1101 Hwy 11 South, Ellisville, MS 39437 | 2006-11-21 |
| 1861578635 | Jennifer Reeder Mascagni | Nurse Practitioner | 1203 Ave B Ste 200, Ellisville, MS 39437 | 2006-10-27 |
| 1336746569 | Jennifer Sharon Isenberg | Nurse Practitioner | 16111 Manchester Rd Ste 202, Ellisville, MO 63011-2489 | 2020-10-01 |
| 1467092783 | Jesse Lee Lawson | Nurse Practitioner | 233 Clarkson Rd, Ellisville, MO 63011-2219 | 2020-01-15 |
| 1376196162 | Betsey Marie Steimel | Nurse Practitioner | 15846 Manchester Rd, Ellisville, MO 63011-2208 | 2019-07-20 |
| 1104338268 | Audrey Heath | Nurse Practitioner | 233 Clarkson Rd, Ellisville, MO 63011-2219 | 2017-10-30 |
| Find all providers in ELLISVILLE | ||||
| City | ELLISVILLE |
| Zip Code | 63011 |
Please comment or provide details below to improve the information on JACOB CRUST.
| 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.