Provider Demographics
NPI:1689302754
Name:KASINGER, JERRI LYNN (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:JERRI
Middle Name:LYNN
Last Name:KASINGER
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 HUDSON LN
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64089-8262
Mailing Address - Country:US
Mailing Address - Phone:660-654-0863
Mailing Address - Fax:
Practice Address - Street 1:105 HUDSON LN
Practice Address - Street 2:
Practice Address - City:SMITHVILLE
Practice Address - State:MO
Practice Address - Zip Code:64089-8262
Practice Address - Country:US
Practice Address - Phone:660-654-0863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-138466-111163WL0100X
MO2010018819163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant