Individual
JEANA RENEE WILCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, RN, APMHCNS
Contact information
Practice address
300 W 19TH TER, KANSAS CITY, MO 64108-2026
(816) 404-6010
Mailing address
504 NW ASHURST PL, LEES SUMMIT, MO 64081-2080
(816) 225-8013
Taxonomy
Speciality
Code
Description
License number
State
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
2019010660
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2019010660
MO STATE BOARD OF NURSING-APRN LICENSE
MO
Enumeration date
05/07/2019
Last updated
05/07/2019
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