Provider Demographics
NPI:1841284239
Name:SCOTT, JENNIFER L (MSN RN FNP)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:L
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MSN RN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11157
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64119-0157
Mailing Address - Country:US
Mailing Address - Phone:913-234-1350
Mailing Address - Fax:913-234-1108
Practice Address - Street 1:7405 RENNER RD
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66217-9414
Practice Address - Country:US
Practice Address - Phone:913-588-2218
Practice Address - Fax:913-588-8529
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO089442163WE0003X
KS53-75582363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO23762021OtherBCBS KC MO NON PAR #
MO429040405Medicaid
P00129377OtherRR MEDICARE GROUP CD1534
P41783Medicare UPIN
MO678000004Medicare PIN