Healthcare Provider Details

I. General information

NPI: 1679815088
Provider Name (Legal Business Name): JESSICA J TAGGART ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2013
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4309 E 50TH TER STE 200
KANSAS CITY MO
64130-8500
US

IV. Provider business mailing address

PO BOX 18412
PALATINE IL
60055-8412
US

V. Phone/Fax

Practice location:
  • Phone: 816-561-8784
  • Fax: 877-286-3519
Mailing address:
  • Phone: 866-525-5484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number2013008387
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: