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NPI Code Detail

MEDICARE: JILL MARIE ROSBRUGH M.D.

MEDICARE: JILL MARIE ROSBRUGH M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0804XChild & Adolescent Psychiatry Physician2008013249MO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P01202806OTHERMOMEDICARE RR

General Provider Information

NPI Number : 1255544698
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILL MARIE ROSBRUGH M.D.
Provider Business Mailing Address
First Line : 211 NE 54TH ST
Second Line : SUITE 201
City : KANSAS CITY
State : MO
Zip : 64118-4390
Country : US
Telephone Number : 816-453-6777
Fax Number : 816-454-3601
Provider Business Practice Location Address
First Line : 211 NE 54TH ST
Second Line : SUITE 201
City : KANSAS CITY
State : MO
Zip : 64118-4390
Country : US
Telephone Number : 816-453-6777
Fax Number : 816-454-3601
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2007
Last Update Date : 04/01/2014

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Directions to “ JILL MARIE ROSBRUGH M.D.” Practice Location

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