Provider Demographics
NPI:1659890648
Name:WESTERMAN, JENNIFER ANN (APRN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:WESTERMAN
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 1:1002 S 4TH ST
Mailing Address - Street 2:PO BOX 184
Mailing Address - City:KIOWA
Mailing Address - State:KS
Mailing Address - Zip Code:67070-0184
Mailing Address - Country:US
Mailing Address - Phone:620-825-4131
Mailing Address - Fax:620-825-4753
Practice Address - Street 1:1002 S 4TH ST
Practice Address - Street 2:
Practice Address - City:KIOWA
Practice Address - State:KS
Practice Address - Zip Code:67070-1825
Practice Address - Country:US
Practice Address - Phone:620-825-4131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-12
Last Update Date:2017-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSTMP-155312363LF0000X
KSTMP155312363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily