Individual
JACKIE D KUMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
2820 E ROCK HAVEN RD STE 210, HARRISONVILLE, MO 64701-4414
(816) 380-7470
(816) 380-3291
Mailing address
2820 E ROCK HAVEN ROAD STE 210, HARRISONVILLE, MO 64701
(816) 380-7470
(816) 380-3291
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
132116
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132116
LICENSE NUMBER
MO
Enumeration date
05/13/2009
Last updated
12/31/2015
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