Provider Demographics
NPI:1942277249
Name:ESKEW, E J (MS APRN BC)
Entity type:Individual
Prefix:MRS
First Name:E
Middle Name:J
Last Name:ESKEW
Suffix:
Gender:F
Credentials:MS APRN BC
Other - Prefix:MRS
Other - First Name:JANAE
Other - Middle Name:J
Other - Last Name:ESKEW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS APRN BC
Mailing Address - Street 1:2685 EAST MAIN STE A
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MO
Mailing Address - Zip Code:63755
Mailing Address - Country:US
Mailing Address - Phone:573-204-1400
Mailing Address - Fax:573-204-1480
Practice Address - Street 1:2685 EAST MAIN STE A
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MO
Practice Address - Zip Code:63755
Practice Address - Country:US
Practice Address - Phone:573-204-1400
Practice Address - Fax:573-204-1480
Is Sole Proprietor?:No
Enumeration Date:2006-03-06
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO130641207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO427529508Medicaid