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Individual

JENNIFER UTTERBACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN-C

Contact information

Practice address
20 NW R.D. MIZE ROAD, EMERGENCY DEPARTMENT, BLUE SPRINGS, MO 64014-4411
(816) 655-5472
Mailing address
201 NW R D MIZE RD, EMERGENCY DEPARTMENT, BLUE SPRINGS, MO 64014-2513
(816) 655-5472

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2013032468
MO
363LF0000X
Family Nurse Practitioner
53-79796-122
KS
363LF0000X
Family Nurse Practitioner
65688
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1174959365
MO
Enumeration date
09/19/2013
Last updated
10/18/2022
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