MEDICARE: JESSA KATHRYN MURRELL

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	235Z00000X	Speech-Language Pathologist	2019036886	MO

General Provider Information

NPI Number	:	1407440621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSA KATHRYN MURRELL

Provider Business Mailing Address
First Line	:	2318 NW LEANN DR
Second Line	:
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64014-1246
Country	:	US
Telephone Number	:	816-205-3931
Fax Number	:

Provider Business Practice Location Address
First Line	:	2318 NW LEANN DR
Second Line	:
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64014-1246
Country	:	US
Telephone Number	:	816-237-0179
Fax Number	:

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

Provider Enumeration Date	:	02/28/2021
Last Update Date	:	07/14/2024

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