Provider Demographics
NPI:1497761944
Name:JENSEN-PRICE, BONNIE K (RNC,FNP)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:K
Last Name:JENSEN-PRICE
Suffix:
Gender:F
Credentials:RNC,FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8550 MARSHALL DR
Mailing Address - Street 2:STE 220
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66214-1505
Mailing Address - Country:US
Mailing Address - Phone:913-495-2220
Mailing Address - Fax:
Practice Address - Street 1:6724 TROOST AVE
Practice Address - Street 2:STE 400
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-1500
Practice Address - Country:US
Practice Address - Phone:816-276-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO053940207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q40602Medicare UPIN
MOK67000018Medicare PIN