Healthcare Provider Details

I. General information

NPI: 1437912466
Provider Name (Legal Business Name): JESSICA LORINE MUELLEMAN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2024
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8656 N AMBASSADOR DR
KANSAS CITY MO
64154-2558
US

IV. Provider business mailing address

PO BOX 871353
KANSAS CITY MO
64187-0353
US

V. Phone/Fax

Practice location:
  • Phone: 816-584-8100
  • Fax: 816-584-8106
Mailing address:
  • Phone: 816-584-8100
  • Fax: 816-584-8106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-82850-011
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2024040583
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: