Healthcare Provider Details

I. General information

NPI: 1164331328
Provider Name (Legal Business Name): LASTAR JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 NW PRYOR RD
LEES SUMMIT MO
64081-1104
US

IV. Provider business mailing address

600 NW PRYOR RD
LEES SUMMIT MO
64081-1104
US

V. Phone/Fax

Practice location:
  • Phone: 816-347-2565
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number2022018438
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: