Organization
WELLCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACLYN B WHITLOCK APRN (APRN/OWNER)
(913) 548-2434
Entity
Organization
Contact information
Practice address
10787 NALL AVE, OVERLAND PARK, KS 66211
(316) 835-1669
Mailing address
6022 MARION ST, SHAWNEE, KS 66218-9254
(913) 548-2434
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/24/2023
Last updated
01/24/2023
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