Healthcare Provider Details

I. General information

NPI: 1366063257
Provider Name (Legal Business Name): JESSICA ERIN BELLEAU APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2020
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date: 04/07/2026
Reactivation Date: 07/29/2026

III. Provider practice location address

330 NE BARRY RD
KANSAS CITY MO
64155-2724
US

IV. Provider business mailing address

330 NE BARRY RD
KANSAS CITY MO
64155-2724
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2026013853
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: