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Individual

DR. JASON A MOBURG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DNP, FNP- BC, APRN

Contact information

Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108
(816) 234-3430
Mailing address
2401 GILLHAM RD, PROVIDER ENROLLMENT, KANSAS CITY, MO 64108-4619
(816) 701-5200
(816) 302-9939

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2018028914
MO

Other

Enumeration date
08/09/2018
Last updated
08/14/2018
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