Individual
JASON EDWARD KIMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
800 W FRONTIER LN, OLATHE, KS 66061-7216
(877) 397-7800
Mailing address
17259 3RD ST, LAWRENCE, KS 66044-9347
(913) 220-8138
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
155240
KS
363LF0000X
Family Nurse Practitioner
Primary
53-77844-072
KS
363LF0000X
Family Nurse Practitioner
AP61106110
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30004593740001
—
KS
01
—
403000037
PTAN
KS
05
—
420080893
—
MO
Enumeration date
09/15/2017
Last updated
04/21/2026
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