Provider Demographics
NPI:1134534811
Name:FEHLMAN, JENNIFER ALBUS (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ALBUS
Last Name:FEHLMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:ASHLEY
Other - Last Name:ALBUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1008 S SPRING AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-2520
Mailing Address - Country:US
Mailing Address - Phone:314-977-1771
Mailing Address - Fax:314-977-1802
Practice Address - Street 1:2315 DOUGHERTY FERRY RD STE 200C
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-3383
Practice Address - Country:US
Practice Address - Phone:314-977-9666
Practice Address - Fax:314-977-9677
Is Sole Proprietor?:No
Enumeration Date:2014-06-21
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014017964207N00000X
MO2018017647207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology