Individual
JACLYN BROOKE WHITLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
6022 MARION ST, SHAWNEE, KS 66218-9254
(913) 213-1352
(949) 561-4135
Mailing address
6022 MARION ST, SHAWNEE, KS 66218-9254
(913) 213-1352
(949) 561-4135
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
53-78241-122
KS
Other
Enumeration date
07/27/2018
Last updated
06/01/2023
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