Healthcare Provider Details

I. General information

NPI: 1386616845
Provider Name (Legal Business Name): JENNIFER L VOOS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 02/18/2022
Certification Date: 02/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 MAIN ST
SABETHA KS
66534-1832
US

IV. Provider business mailing address

PO BOX 247
SABETHA KS
66534-0247
US

V. Phone/Fax

Practice location:
  • Phone: 785-284-2141
  • Fax: 785-284-0022
Mailing address:
  • Phone: 785-284-2141
  • Fax: 785-284-0022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1500741
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: