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General NPI Number Information
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NPI Number | 1568040566
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Entity Type | Organization
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Legal Business Name | CARE BEYOND THE BOULEVARD
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Dates
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Enumeration Date | 03/31/2021
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Last Update Date | 11/01/2023
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Provider Practice Location Address
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Address Line | 3150 FIBERGLASS RD
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City | KANSAS CITY
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State | KS
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Zip | 66115
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Country | US
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Telephone | 913-291-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 3150 FIBERGLASS RD
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City | KANSAS CITY
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State | KS
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Zip | 66115
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Country | US
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Telephone | 913-291-2273
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Fax |
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Authorized Official
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Title or Position | FOUNDER/CEO
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Name | JAYNELL ASSMAN
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Credential | NP
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Telephone | 913-291-2273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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