Provider Demographics
NPI:1720605033
Name:REYNOLDS, JAMEL SATIN (PA-C)
Entity Type:Individual
Prefix:
First Name:JAMEL
Middle Name:SATIN
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:5501 NW 62ND TER STE 100
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64151-2412
Mailing Address - Country:US
Mailing Address - Phone:816-842-4440
Mailing Address - Fax:816-842-1974
Practice Address - Street 1:1133 W KANSAS ST
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-2281
Practice Address - Country:US
Practice Address - Phone:816-781-7400
Practice Address - Fax:816-781-3315
Is Sole Proprietor?:No
Enumeration Date:2020-07-02
Last Update Date:2022-10-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2020004138363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant