Provider Demographics
NPI:1043548696
Name:MCCLYMONT, JANELLE LEANN (APN)
Entity Type:Individual
Prefix:MRS
First Name:JANELLE
Middle Name:LEANN
Last Name:MCCLYMONT
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
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Mailing Address - Street 1:5501 NW 62ND TERRACE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64151-2408
Mailing Address - Country:US
Mailing Address - Phone:816-584-8884
Mailing Address - Fax:913-945-9612
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:SUITE G600
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-8500
Practice Address - Country:US
Practice Address - Phone:913-588-9600
Practice Address - Fax:913-588-9770
Is Sole Proprietor?:No
Enumeration Date:2009-11-19
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS53-76173K363L00000X
MO2000148328363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1043548696Medicaid
MOMA2231021Medicare PIN