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General NPI Number Information
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NPI Number | 1467049411
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Entity Type | Individual
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Provider Name | JENNIE LOU MCNELLIS PHARM D
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Gender | Female
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Dates
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Enumeration Date | 12/23/2020
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Last Update Date | 12/23/2020
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Provider Practice Location Address
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Address Line | 11144 RENNER BLVD
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City | LENEXA
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State | KS
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Zip | 66219-9621
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Country | US
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Telephone | 913-647-4610
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Fax |
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Provider Business Mailing Address
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Address Line | 1730 HARBOR DR
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City | KEARNEY
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State | MO
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Zip | 64060-8828
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Country | US
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Telephone | 816-447-7093
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2008033125
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 1-108088
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License Number State | KS
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