Individual
JACOB KESSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3901 RAINBOW BLVD, KANSAS CITY, KS 66160-8500
(913) 588-5000
Mailing address
12117 W 99TH ST, LENEXA, KS 66215-1660
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
14-142778-122
KS
163W00000X
Registered Nurse
252662
GA
367500000X
Certified Registered Nurse Anesthetist
155909
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
43-557576-122
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326552282
—
KS
Enumeration date
11/29/2017
Last updated
05/11/2018
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