Provider Demographics
NPI:1073526299
Name:WITT, JACKI SUE (MSN, RNC, WHNP)
Entity Type:Individual
Prefix:MS
First Name:JACKI
Middle Name:SUE
Last Name:WITT
Suffix:
Gender:F
Credentials:MSN, RNC, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3801 NE 77TH ST
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:MO
Mailing Address - Zip Code:64119-1267
Mailing Address - Country:US
Mailing Address - Phone:816-235-1700
Mailing Address - Fax:816-235-1701
Practice Address - Street 1:TRUMAN MEDICAL CENTER 2301 HOLMES ROAD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108
Practice Address - Country:US
Practice Address - Phone:816-235-1700
Practice Address - Fax:816-235-1701
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO075834363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health