Provider Demographics
NPI:1164185690
Name:ROBERTS, JESSICA MICHELLE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:MICHELLE
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 SHAWNEE MISSION PKWY
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2003
Mailing Address - Country:US
Mailing Address - Phone:913-588-7750
Mailing Address - Fax:
Practice Address - Street 1:2650 SHAWNEE MISSION PKWY
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:KS
Practice Address - Zip Code:66205-2003
Practice Address - Country:US
Practice Address - Phone:913-588-7750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-21
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5380423022363L00000X
MO2021029245363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner