Provider Demographics
NPI:1134191596
Name:PRICE, JOLENE SUE (FNP)
Entity type:Individual
Prefix:MS
First Name:JOLENE
Middle Name:SUE
Last Name:PRICE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7600 NW BELVIDERE PKWY
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64152-2298
Mailing Address - Country:US
Mailing Address - Phone:816-308-5297
Mailing Address - Fax:816-741-1997
Practice Address - Street 1:7600 NW BELVIDERE PKWY
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64152-2298
Practice Address - Country:US
Practice Address - Phone:816-308-5297
Practice Address - Fax:816-741-1997
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO120997363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO4287244405Medicaid
MO4287244405Medicaid
MOS36912Medicare UPIN