Provider Demographics
NPI:1972269892
Name:MEIRINK, JACQUELINE MICHELLE (FNP)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:MICHELLE
Last Name:MEIRINK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:
Other - Last Name:HALL, AND WEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:39335 LONESTAR RD
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:KS
Mailing Address - Zip Code:66026-7664
Mailing Address - Country:US
Mailing Address - Phone:913-522-7604
Mailing Address - Fax:
Practice Address - Street 1:14109 OVERBROOK RD STE D
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66224-4519
Practice Address - Country:US
Practice Address - Phone:913-291-2110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-15
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-80170-111363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily