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Organization
PHOENIX RISING TELEPSYCH
Active
Organization
PHOENIX RISING TELEPSYCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACLYN MCINTYRE APRN (OWNER)
(913) 398-2530
Entity
Organization
Contact information
Practice address
6917 TOMAHAWK RD, PRAIRIE VILLAGE, KS 66208-2618
(913) 398-2530
Mailing address
PO BOX 8544, PRAIRIE VILLAGE, KS 66208-0544
(913) 398-2530
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/22/2024
Last updated
10/30/2024
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