Provider Demographics
NPI:1760052807
Name:SINGLETON, JUANITA (LPN)
Entity Type:Individual
Prefix:MS
First Name:JUANITA
Middle Name:
Last Name:SINGLETON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 410502
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64141-0502
Mailing Address - Country:US
Mailing Address - Phone:913-972-0791
Mailing Address - Fax:
Practice Address - Street 1:3210 MICHIGAN AVE STE 161
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64109-3102
Practice Address - Country:US
Practice Address - Phone:913-972-0791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO056837164W00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No101Y00000XBehavioral Health & Social Service ProvidersCounselor