MEDICARE: MS. JOLENE SUE PRICE 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	363L00000X	Nurse Practitioner	120997	MO

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	:	1134191596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOLENE SUE PRICE FNP

Provider Business Mailing Address
First Line	:	7600 NW BELVIDERE PKWY
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64152-2298
Country	:	US
Telephone Number	:	816-308-5297
Fax Number	:	816-741-1997

Provider Business Practice Location Address
First Line	:	7600 NW BELVIDERE PKWY
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64152-2298
Country	:	US
Telephone Number	:	816-308-5297
Fax Number	:	816-741-1997

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

Provider Enumeration Date	:	02/01/2006
Last Update Date	:	05/05/2011

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