Healthcare Provider Details

I. General information

NPI: 1982329249
Provider Name (Legal Business Name): JESSIE A DENZIN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2022
Last Update Date: 08/22/2023
Certification Date: 08/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8550 MARSHALL DR STE 200
LENEXA KS
66214-9836
US

IV. Provider business mailing address

8550 MARSHALL DR STE 220
LENEXA KS
66214-9836
US

V. Phone/Fax

Practice location:
  • Phone: 913-495-2208
  • Fax: 913-495-3715
Mailing address:
  • Phone: 913-451-4443
  • Fax: 913-495-3732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number81531
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: