MEDICARE: JENNY SUE DEAN-BATSON RNC,WHNP

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
1	363LW0102X	Women's Health Nurse Practitioner	127421	MO

General Provider Information

NPI Number	:	1366437451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNY SUE DEAN-BATSON RNC,WHNP

Provider Business Mailing Address
First Line	:	1506 OKLAHOMA AVE
Second Line	:	P.O. 278
City	:	TRENTON
State	:	MO
Zip	:	64683-2587
Country	:	US
Telephone Number	:	660-359-2855
Fax Number	:	660-359-2855

Provider Business Practice Location Address
First Line	:	1506 OKLAHOMA AVE
Second Line	:	P.O. 278
City	:	TRENTON
State	:	MO
Zip	:	64683-2587
Country	:	US
Telephone Number	:	660-359-2855
Fax Number	:	660-359-2855

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	07/08/2007

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