MEDICARE: JENNIFER CATANAOAN SANTIAGO FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	138186	MO
2	163W00000X	Registered Nurse	14-73960-062	KS
3	363LF0000X	Family Nurse Practitioner	138186	MO
4	363LF0000X	Family Nurse Practitioner	45598	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033119938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER CATANAOAN SANTIAGO FNP

Provider Business Mailing Address
First Line	:	500A SE 3RD TER
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64063-2862
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3801 BLUE PKWY
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64130-2807
Country	:	US
Telephone Number	:	816-922-7645
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	04/18/2011

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