Provider Demographics
NPI:1366753238
Name:REDFERN, JENNIFER A (OD)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:A
Last Name:REDFERN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:100 PIPER HILL DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-1616
Mailing Address - Country:US
Mailing Address - Phone:636-928-3937
Mailing Address - Fax:636-928-0661
Practice Address - Street 1:100 PIPER HILL DR
Practice Address - Street 2:SUITE D
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-1616
Practice Address - Country:US
Practice Address - Phone:636-928-3937
Practice Address - Fax:636-928-0661
Is Sole Proprietor?:No
Enumeration Date:2010-06-25
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010020682152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist