Provider Demographics
NPI:1851699268
Name:KEELER, JESSICA LEE (RNFA)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LEE
Last Name:KEELER
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5340 COLLEGE BLVD
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1621
Mailing Address - Country:US
Mailing Address - Phone:816-942-0200
Mailing Address - Fax:816-942-0205
Practice Address - Street 1:5340 COLLEGE BLVD
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1621
Practice Address - Country:US
Practice Address - Phone:816-942-0200
Practice Address - Fax:816-942-0205
Is Sole Proprietor?:No
Enumeration Date:2011-03-09
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-102166-051163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical