Individual
JEANINE R. SHOWALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC; AOCNP
Contact information
Practice address
12140 NALL AVE, SUITE 200, OVERLAND PARK, KS 66209-2503
(913) 498-7409
(913) 498-7470
Mailing address
12140 NALL AVE, SUITE 200, OVERLAND PARK, KS 66209-2503
(913) 498-7409
(913) 498-7470
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
14-84910-102
KS
163W00000X
Registered Nurse
2000165819
MO
363LF0000X
Family Nurse Practitioner
Primary
45928
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306952379
—
MO
05
—
200407400B
—
KS
Enumeration date
08/22/2006
Last updated
02/01/2022
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