Healthcare Provider Details

I. General information

NPI: 1508212408
Provider Name (Legal Business Name): JENNIFER ESPY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2016
Last Update Date: 05/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5721 W 119TH ST
OVERLAND PARK KS
66209-3722
US

IV. Provider business mailing address

5721 W 119TH ST
OVERLAND PARK KS
66209-3722
US

V. Phone/Fax

Practice location:
  • Phone: 913-498-6000
  • Fax:
Mailing address:
  • Phone: 913-498-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number53-44707-062
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: