Provider Demographics
NPI:1245113067
Name:ST LOUIS, JENSY
Entity type:Individual
Prefix:
First Name:JENSY
Middle Name:
Last Name:ST LOUIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 RIVER POINTE WAY APT 6305
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-3916
Mailing Address - Country:US
Mailing Address - Phone:857-246-2532
Mailing Address - Fax:
Practice Address - Street 1:300 ROSEWOOD DR STE 103
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-1389
Practice Address - Country:US
Practice Address - Phone:978-278-3320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN10011725163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse