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Individual

CAROL ELAINE JESPERSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
4911 STATE AVE, KANSAS CITY, KS 66102-1749
(913) 287-8851
Mailing address
27 CIRCLE DR, PAOLA, KS 66071-1115
(785) 979-7002

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
13-100453-122
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100211880C
KS
05
100211880D
KS
Enumeration date
03/15/2011
Last updated
03/15/2011
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