Basic Information
Provider Information
NPI: 1629269519
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALEXANDER-BRETT
FirstName: JENNIFER
MiddleName: MARIE
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 660 S EUCLID AVE
Address2: CB 8052
City: SAINT LOUIS
State: MO
PostalCode: 631101010
CountryCode: US
TelephoneNumber: 3144548917
FaxNumber: 3147472200
Practice Location
Address1: 4921 PARKVIEW PL
Address2: STE 8B
City: SAINT LOUIS
State: MO
PostalCode: 631101032
CountryCode: US
TelephoneNumber: 3144548917
FaxNumber: 3147472200
Other Information
ProviderEnumerationDate: 08/06/2007
LastUpdateDate: 11/15/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001X2010037606MOY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

ID Information
IDTypeStateIssuerDescription
20001242705MO MEDICAID


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