Individual
JENNY S ECORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.R.N.P.
Contact information
Practice address
3243 E MURDOCK ST, WICHITA, KS 67208-3052
(316) 500-8900
Mailing address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3000
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
44567
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200104550B
—
OK
05
—
200421040B
—
KS
Enumeration date
06/13/2005
Last updated
11/04/2014
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