Provider Demographics
NPI:1770139545
Name:JEAN BAPTISTE, DIAMOND (FNP-C)
Entity type:Individual
Prefix:
First Name:DIAMOND
Middle Name:
Last Name:JEAN BAPTISTE
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21530 W 54TH ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66226-9768
Mailing Address - Country:US
Mailing Address - Phone:903-215-1514
Mailing Address - Fax:
Practice Address - Street 1:4800 W 135TH ST STE 200
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66224-8721
Practice Address - Country:US
Practice Address - Phone:913-261-9855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-16
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025003964363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNJEA011687890OtherBLUE CROSS BLUE SHIELD