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NPI Code Detail

MEDICARE: JEAN M KAEBERLE APRN

MEDICARE: JEAN M KAEBERLE APRN
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
1363LA2100XAcute Care Nurse Practitioner76582KS
2363LF0000XFamily Nurse Practitioner76582KS

General Provider Information

NPI Number : 1578966503
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEAN M KAEBERLE APRN
Provider Business Mailing Address
First Line : 901 E 104TH ST
Second Line :
City : KANSAS CITY
State : MO
Zip : 64131-4517
Country : US
Telephone Number : 913-588-1200
Fax Number :
Provider Business Practice Location Address
First Line : 11900 W 135TH ST
Second Line :
City : OVERLAND PARK
State : KS
Zip : 66221-9400
Country : US
Telephone Number : 866-389-2727
Fax Number : 401-216-3854
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2014
Last Update Date : 01/21/2020

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