Provider Demographics
NPI:1003903675
Name:KEAST, JILL S (RN, MSN, ARNP-C)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:S
Last Name:KEAST
Suffix:
Gender:F
Credentials:RN, MSN, ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 CAMBRIDGE ST STE G600
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-8501
Mailing Address - Country:US
Mailing Address - Phone:913-588-9600
Mailing Address - Fax:
Practice Address - Street 1:4000 CAMBRIDGE ST STE G600
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-8500
Practice Address - Country:US
Practice Address - Phone:913-588-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO090489363LA2200X
KS44758363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100319810CMedicaid
MO1003903675Medicaid
KS160137OtherBCBS KS OUTREACH CLINICS
KS100319810AMedicaid
26354011OtherBCBS KC
26354011OtherBCBS KC
S64846Medicare UPIN
KS100319810CMedicaid
KS110220020Medicare PIN
KS0388563BMedicare PIN
MO1003903675Medicaid
KS160137Medicare PIN
KS100319810AMedicaid
MO0388563AMedicare PIN