Healthcare Provider Details

I. General information

NPI: 1841284239
Provider Name (Legal Business Name): JENNIFER L SCOTT MSN RN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 10/04/2022
Certification Date: 10/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7405 RENNER RD
SHAWNEE KS
66217-9414
US

IV. Provider business mailing address

PO BOX 11157
KANSAS CITY MO
64119-0157
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-2218
  • Fax: 913-588-8529
Mailing address:
  • Phone: 913-234-1350
  • Fax: 913-234-1108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number53-75582
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number089442
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: