Provider Demographics
NPI:1245457217
Name:ADMA, JYOTSNA (MD)
Entity type:Individual
Prefix:
First Name:JYOTSNA
Middle Name:
Last Name:ADMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JYOTSNA
Other - Middle Name:
Other - Last Name:PALARAPU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15316 PERRY ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66221-7504
Mailing Address - Country:US
Mailing Address - Phone:913-962-1398
Mailing Address - Fax:
Practice Address - Street 1:4300 BRENNER DR
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66104-1163
Practice Address - Country:US
Practice Address - Phone:913-890-7400
Practice Address - Fax:913-334-0284
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04313792084P0800X, 2084P0804X
IL036.1536402084P0804X
MO20070122222084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036.153640OtherILLINOIS LICENSE