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Individual

JENESIS COUNCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6213 E 108TH ST, KANSAS CITY, MO 64134-2530
(816) 912-7803
Mailing address
2611 SW 117TH STREET #223, TOPEKA, KS 66604
(816) 912-7900

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
T-014-079
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
832977449
KS
Enumeration date
01/29/2019
Last updated
01/29/2019
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