Provider Demographics
NPI:1205828670
Name:HOLLINGSWORTH, JANELLE RAE (RN MSN FNP-BC)
Entity Type:Individual
Prefix:
First Name:JANELLE
Middle Name:RAE
Last Name:HOLLINGSWORTH
Suffix:
Gender:F
Credentials:RN MSN FNP-BC
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Mailing Address - Street 1:3521 NE RALPH POWELL RD
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-2337
Mailing Address - Country:US
Mailing Address - Phone:816-554-8346
Mailing Address - Fax:816-554-9470
Practice Address - Street 1:3521 NE RALPH POWELL RD
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-2337
Practice Address - Country:US
Practice Address - Phone:816-554-8346
Practice Address - Fax:816-554-9470
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2022-08-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO146402363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO425829900Medicaid
P37599Medicare UPIN
MO425829900Medicaid