MEDICARE: WHITNEY PEPPER JACKSON PA

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	363A00000X	Physician Assistant	15-03127	KS

General Provider Information

NPI Number	:	1164238648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WHITNEY PEPPER JACKSON PA

Provider Business Mailing Address
First Line	:	2200 SW 6TH AVE STE 104
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66606-1707
Country	:	US
Telephone Number	:	785-354-8518
Fax Number	:	785-354-1255

Provider Business Practice Location Address
First Line	:	4201B ANDERSON AVE STE 2
Second Line	:
City	:	MANHATTAN
State	:	KS
Zip	:	66503-7601
Country	:	US
Telephone Number	:	785-320-7774
Fax Number	:	785-320-7758

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

Provider Enumeration Date	:	12/09/2024
Last Update Date	:	06/08/2026

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Directions to “ WHITNEY PEPPER JACKSON PA” Practice Location

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