MEDICARE: MRS. JENNA LYNN BEUERLEIN M.S. CCC-SLP

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	3367	KS

General Provider Information

NPI Number	:	1548504673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNA LYNN BEUERLEIN M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	8247 LEAVENWORTH ROAD
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66109
Country	:	US
Telephone Number	:	913-703-4037
Fax Number	:

Provider Business Practice Location Address
First Line	:	8247 LEAVENWORTH RD
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66109-1574
Country	:	US
Telephone Number	:	913-703-4037
Fax Number	:

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

Provider Enumeration Date	:	11/15/2012
Last Update Date	:	07/21/2022

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