Healthcare Provider Details

I. General information

NPI: 1851269385
Provider Name (Legal Business Name): JAZMINE B HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAZMINE B FISHER

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 10/27/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4320 WORNALL RD STE 208
KANSAS CITY MO
64111-5964
US

IV. Provider business mailing address

4320 WORNALL RD STE 208
KANSAS CITY MO
64111-5964
US

V. Phone/Fax

Practice location:
  • Phone: 816-531-0552
  • Fax: 816-756-2503
Mailing address:
  • Phone: 816-531-0552
  • Fax: 816-756-2503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number2025046185
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: