Individual
MRS. JESSICA LYNN BLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-C
Contact information
Practice address
9229 WARD PKWY STE 380, KANSAS CITY, MO 64114-5471
(816) 319-4785
Mailing address
1000 W 10TH ST, ROLLA, MO 65401-2905
(573) 364-9000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2016001991
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649630823
—
MO
Enumeration date
03/01/2016
Last updated
09/02/2020
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