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General NPI Number Information
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NPI Number | 1326552282
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Entity Type | Individual
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Provider Name | JACOB KESSEN CRNA
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Gender | Male
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Dates
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Enumeration Date | 11/29/2017
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Last Update Date | 05/11/2018
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Provider Practice Location Address
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Address Line | 3901 RAINBOW BLVD
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City | KANSAS CITY
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State | KS
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Zip | 66160-8500
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Country | US
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Telephone | 913-588-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 12117 W 99TH ST
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City | LENEXA
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State | KS
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Zip | 66215-1660
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 252662
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 14-142778-122
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 155909
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License Number State | KS
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 43-557576-122
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License Number State | KS
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