Provider Demographics
NPI:1093528317
Name:JAMERSON, KELSI GAIL (FNP)
Entity type:Individual
Prefix:
First Name:KELSI
Middle Name:GAIL
Last Name:JAMERSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12704 W 138TH PL
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66221-4141
Mailing Address - Country:US
Mailing Address - Phone:913-982-6128
Mailing Address - Fax:
Practice Address - Street 1:22700 W 55TH TER
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66226-5602
Practice Address - Country:US
Practice Address - Phone:913-422-1825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-30
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS84030363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily