Individual
JENNIFER LEAH CAROLLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
19550 E 39TH ST S STE 300, INDEPENDENCE, MO 64057-2306
(816) 478-0220
(816) 794-3483
Mailing address
19550 E 39TH ST S STE 300, INDEPENDENCE, MO 64057-2306
(816) 478-0220
(816) 795-3483
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2017003020
MO
363LW0102X
Women's Health Nurse Practitioner
Primary
2025008123
MO
Other
Enumeration date
03/15/2025
Last updated
03/15/2025
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