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General NPI Number Information
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NPI Number | 1649874058
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Entity Type | Individual
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Provider Name | JENNIFER KAY ANDERSON MSN, FNP-C, CPEN
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Gender | Female
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Dates
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Enumeration Date | 11/25/2020
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Last Update Date | 11/25/2020
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Provider Practice Location Address
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Address Line | 2401 GILLHAM RD
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City | KANSAS CITY
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State | MO
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Zip | 64108-4619
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Country | US
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Telephone | 816-701-5200
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Fax | 302-993-9816
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Provider Business Mailing Address
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Address Line | 16475 371 HWY
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City | PLATTE CITY
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State | MO
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Zip | 64079-9725
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Country | US
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Telephone | 816-694-8711
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2020030275
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License Number State | MO
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