Provider Demographics
NPI:1558791236
Name:MCKECHNIE, JENNIFER PAIGE (APRN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:PAIGE
Last Name:MCKECHNIE
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 1:11111 NALL AVE STE 116
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1625
Mailing Address - Country:US
Mailing Address - Phone:913-451-0600
Mailing Address - Fax:913-451-0601
Practice Address - Street 1:11111 NALL AVE STE 116
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1625
Practice Address - Country:US
Practice Address - Phone:913-451-0600
Practice Address - Fax:913-451-0601
Is Sole Proprietor?:No
Enumeration Date:2013-11-18
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5376083011363LF0000X
KS53-76083-011363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily