Basic Information
| Provider Information | |||||||||
| NPI: | 1841284239 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCOTT | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MSN RN FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 11157 | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641190157 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9132341350 | ||||||||
| FaxNumber: | 9132341108 | ||||||||
| Practice Location | |||||||||
| Address1: | 7405 RENNER RD | ||||||||
| Address2: | |||||||||
| City: | SHAWNEE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662179414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9135882218 | ||||||||
| FaxNumber: | 9135888529 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2005 | ||||||||
| LastUpdateDate: | 10/04/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WE0003X | 089442 | MO | N | Nursing Service Providers | Registered Nurse | Emergency | 363LP2300X | 53-75582 | KS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care |
ID Information
| ID | Type | State | Issuer | Description | 23762021 | 01 | MO | BCBS KC MO NON PAR # | OTHER | 429040405 | 05 | MO | MEDICAID | P00129377 | 01 | RR MEDICARE GROUP CD1534 | OTHER |