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Jessica Leigh Fegan

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

3015 N Ballas Rd, Saint Louis, MO 63131-2329

PECOS Enrollment

This provider is enrolled in PECOS as JESSICA FEGAN.

Based on the most recent information from CMS, provider Jessica Leigh Fegan is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1467947317
Provider Type
Individual
Full Name
Fegan, Jessica Leigh
Credential
APRN

Gender
Female
Sole Proprietor
Yes
Enumeration Date
6/23/2018
Last Updated
10/13/2025

Contact Information

Practice Location

3015 N Ballas Rd, Saint Louis, MO 63131-2329

(314) 996-5772

(314) 996-7691

Mailing Location

'PO Box 959354 St Louis Mo 63195', Saint Louis, MO 63195-0001

(314) 996-5772

(314) 996-7691

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 2018030057 Missouri
Code 163WC0200X	Description Registered Nurse Nursing Service Providers	License 2012016897 Missouri

Provider Identifiers

ID	Description	Issuer
ID 2012016897	Description Other	Issuer RN LICENSE Missouri

Jessica Leigh Fegan

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Brice, Mary H

Tanzyus, Tyler R

Wegener, Maeghan Ashlee

Shahinaj, Loreta

Bradshaw, Morgan Michelle

Harte, Tanya

Simms, Stephanie M

Huenefeldt, Elizabeth Ann

Kemner, Anna Marie

Hopper, Stacy