Healthcare Provider Details

I. General information

NPI: 1790777548
Provider Name (Legal Business Name): JINA L. PATTON ACNP-PP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2005
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 NE SAINT LUKES BLVD STE 330
LEES SUMMIT MO
64086-6001
US

IV. Provider business mailing address

20 NE SAINT LUKES BLVD STE 330
LEES SUMMIT MO
64086-6001
US

V. Phone/Fax

Practice location:
  • Phone: 816-347-4420
  • Fax: 816-347-4421
Mailing address:
  • Phone: 816-347-4420
  • Fax: 816-347-4421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number2016041517
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number53-75583-121
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: