Provider Demographics
NPI:1740857887
Name:AXMEAR, JESSICA ADRIENNE (DNP, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:ADRIENNE
Last Name:AXMEAR
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:ADRIENNE
Other - Last Name:AXMEAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1000 SW TWIN CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-3200
Mailing Address - Country:US
Mailing Address - Phone:816-695-6764
Mailing Address - Fax:
Practice Address - Street 1:3515 BROADWAY BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-2501
Practice Address - Country:US
Practice Address - Phone:816-753-5144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021019788363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health