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NPI Code Detail

MEDICARE: KAITLYN ELIZABETH JACKSON

MEDICARE: KAITLYN ELIZABETH JACKSON
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner53-85298-012KS

General Provider Information

NPI Number : 1134070246
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAITLYN ELIZABETH JACKSON
Provider Business Mailing Address
First Line : 13351 S ARAPAHO DR
Second Line :
City : OLATHE
State : KS
Zip : 66062-1520
Country : US
Telephone Number : 913-353-3000
Fax Number :
Provider Business Practice Location Address
First Line : 13351 S ARAPAHO DR
Second Line :
City : OLATHE
State : KS
Zip : 66062-1520
Country : US
Telephone Number : 913-353-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2026
Last Update Date : 02/23/2026

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Directions to “ KAITLYN ELIZABETH JACKSON ” Practice Location

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