Healthcare Provider Details

I. General information

NPI: 1336075092
Provider Name (Legal Business Name): JENNIFER MICHELLE HUTSELL RN-BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4294 OAKLAND SCHOOL RD
MAYVIEW MO
64071-8192
US

IV. Provider business mailing address

4294 OAKLAND SCHOOL RD
MAYVIEW MO
64071-8192
US

V. Phone/Fax

Practice location:
  • Phone: 660-259-2203
  • Fax: 660-259-6804
Mailing address:
  • Phone: 660-259-2203
  • Fax: 660-259-6804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number2014021306
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: