| Doctor Name: | JESSICA WHELAN |
| NPI Number: | 1033544747 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PMHNP-BC |
| License Number: | 2013029034 |
| Business Practice Address: | 10199 Woodfield Lane Suite 10 Olivette, MO - 631322922 |
| Business Phone Number: | 3142980023 |
| Business Fax Number: | 3149971111 |
| Mailing Address: | 10199 Woodfield Lane, Suite 10 OLIVETTE |
| State: | MO |
| Postal Code: | 631322922 |
| Phone Number: | 3142980023 |
| Fax Number: | 3149971111 |
| NPI Enumeration Date: | 09/12/2013 |
| NPI Last Update Date: | 11/30/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 2013029034 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |