Healthcare Provider Details

I. General information

NPI: 1376403535
Provider Name (Legal Business Name): JENNIFER LYNN CARLIN APRN PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/12/2025
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10300 W 103RD ST
OVERLAND PARK KS
66214-2642
US

IV. Provider business mailing address

10300 W 103RD ST
OVERLAND PARK KS
66214-2642
US

V. Phone/Fax

Practice location:
  • Phone: 816-500-2070
  • Fax: 816-307-5511
Mailing address:
  • Phone: 816-500-2070
  • Fax: 816-307-5511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2025048833
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5385292121
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: