Provider Demographics
NPI:1639116346
Name:DENNIS, JANICE B (RN, BC, M-SCNS)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:B
Last Name:DENNIS
Suffix:
Gender:F
Credentials:RN, BC, M-SCNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E 104TH ST
Mailing Address - Street 2:MAILSTOP 400S
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131
Mailing Address - Country:US
Mailing Address - Phone:816-502-7117
Mailing Address - Fax:816-932-9670
Practice Address - Street 1:4330 WORNALL RD
Practice Address - Street 2:SUITE 2000
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-5939
Practice Address - Country:US
Practice Address - Phone:816-931-1883
Practice Address - Fax:816-756-3645
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO88624364SM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100452130DMedicaid
MOP00836079OtherRAILROAD MEDICARE
KS100452130CMedicaid
MO429206808Medicaid
KS100452130AMedicaid
KSP00842725OtherRAILROAD MEDICARE
KS100452130DMedicaid
MOMA2491010Medicare PIN
MOP00836079OtherRAILROAD MEDICARE
KS100452130AMedicaid
KSKA1724047Medicare PIN