Provider Demographics
NPI:1093422560
Name:JENNINGS, TAYLOR RAY (FNP)
Entity Type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:RAY
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:TAYLOR
Other - Middle Name:RAY
Other - Last Name:HOWARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-884-3300
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:500 N KEENE ST
Practice Address - Street 2:STE 305
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-8370
Practice Address - Country:US
Practice Address - Phone:573-882-5673
Practice Address - Fax:573-884-0380
Is Sole Proprietor?:No
Enumeration Date:2022-11-03
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022043661363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily