Provider Demographics
NPI:1821214438
Name:JENKINS, LORICIA LEA (CRNA)
Entity Type:Individual
Prefix:
First Name:LORICIA
Middle Name:LEA
Last Name:JENKINS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:25012 W. 86TH TERRACE
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66227-3522
Mailing Address - Country:US
Mailing Address - Phone:316-304-3144
Mailing Address - Fax:913-745-5909
Practice Address - Street 1:1209 NW NORTH RIDGE DRIVE, SUITE B
Practice Address - Street 2:ANESTHESIA SERVICES OF BLUE SPRINGS
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014-6320
Practice Address - Country:US
Practice Address - Phone:816-988-8415
Practice Address - Fax:816-988-8395
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS55593367500000X
MO2007012542367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO915473904Medicaid
KSP00430884OtherRAILROAD MEDICARE
KS200504010AMedicaid
KSP00430884OtherRAILROAD MEDICARE