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Individual

JENNIE M AUSTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2401 GILLHAM RD, CHILDREN'S MERCY, KANSAS CITY, MO 64108-4619
(816) 234-3000
(816) 234-3000
Mailing address
2401 GILLHAM RD, CHILDREN'E MERCY, KANSAS CITY, MO 64108-4619
(816) 234-3000
(816) 234-3000

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2005031069
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200974
BLUE CROSS BLUE SHIELD
01
204990105
MEDICAID
MO
05
204990105
MO
01
440546366
UNITED HEALTHCARE
01
507515500
MEDICAID
MO
01
721499
HEALTHLINK
01
H63439
MERCY
Enumeration date
04/20/2006
Last updated
08/15/2012
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