Individual provider · Type 1 NPI

Jesse R. Chisum, BSN, RN

Ambulatory Care Registered Nurse · St. Louis, MO

NPI number 1013850072 Active

Practice location

4974 Manchester Ave
St. Louis, MO 63110-2010

Mailing address

915 N Grand Blvd
St. Louis, MO 63106-1621

Specialties and licenses

TaxonomyCodeLicense
Ambulatory Care Registered Nurse Primary 163WP2201X2010029883 (MO)

Ambulatory Care Registered Nurse: Definition to come...

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About NPI 1013850072

Jesse R. Chisum, BSN, RN's National Provider Identifier is 1013850072, issued on Apr 13, 2026. The primary taxonomy on file is Ambulatory Care Registered Nurse (163WP2201X), and the practice location is in St. Louis, MO. The record was last updated on Apr 13, 2026.