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NPI Code Detail

MEDICARE: JILL ANDERSON

MEDICARE: JILL ANDERSON
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
1101YP2500XProfessional Counselor3496KS

General Provider Information

NPI Number : 1255953105
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILL ANDERSON
Provider Business Mailing Address
First Line : 3216 GILLHAM PLZ
Second Line :
City : KANSAS CITY
State : MO
Zip : 64109-1742
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3216 GILLHAM PLZ
Second Line :
City : KANSAS CITY
State : MO
Zip : 64109-1742
Country : US
Telephone Number : 816-533-5698
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2020
Last Update Date : 05/14/2020

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Directions to “ JILL ANDERSON ” Practice Location

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