Provider Demographics
NPI:1780957290
Name:GRANT, JENNIFER ANN (APRN)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ANN
Last Name:GRANT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:JENNIFER
Other - Middle Name:ANN
Other - Last Name:BOSLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:1609 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:MO
Mailing Address - Zip Code:64060
Mailing Address - Country:US
Mailing Address - Phone:816-341-3132
Mailing Address - Fax:660-493-2796
Practice Address - Street 1:4741 S ARROWHEAD DR SUITE 13
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055
Practice Address - Country:US
Practice Address - Phone:816-795-6000
Practice Address - Fax:816-795-6064
Is Sole Proprietor?:No
Enumeration Date:2012-02-14
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-117878-121163W00000X
MO2001016497363LF0000X
KS53-75607-121363LF0000X
MO2012008574363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse