Roth, Jennifer Diane

Roth, Jennifer Diane is an individual health care provider with primary practice located at 1723 Broadway St Ste 315 , Cape Girardeau MO 63701-4556. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Roth, Jennifer Diane can be contacted via phone (573) 519-4960.

Contact Information

Primary practice address
1723 Broadway St Ste 315 Cape Girardeau MO 63701-4556
Phone: (573) 519-4960
Fax: (573) 519-4655
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 2019024741 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 2019024741 Missouri

Profile Details

NPI number 1477105427
LBN Legal business name Roth, Jennifer Diane
Credentials FNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2019
Last updated Sep 26th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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