Healthcare Provider Details

I. General information

NPI: 1780569475
Provider Name (Legal Business Name): JENNIFER LYNN STOUTENBURG RPSGT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 E LINWOOD BLVD ATTN: SLEEP LAB, M11.356 (111)
KANSAS CITY MO
64128-2226
US

IV. Provider business mailing address

4801 E LINWOOD BLVD ATTN: SLEEP LAB, M11.356 (111)
KANSAS CITY MO
64128-2226
US

V. Phone/Fax

Practice location:
  • Phone: 816-861-4700
  • Fax: 816-922-4866
Mailing address:
  • Phone: 816-861-4700
  • Fax: 816-922-4866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225500000X
TaxonomyRespiratory/Developmental/Rehabilitative Specialist/Technologist
License Number740
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code225500000X
TaxonomyRespiratory/Developmental/Rehabilitative Specialist/Technologist
License Number11575
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: