Individual
DR. BREAUNNAH BLOOMER JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10918 ELM AVE STE 102, KANSAS CITY, MO 64134-2284
(816) 767-4346
(816) 251-6367
Mailing address
901 E 104TH ST, KANSAS CITY, MO 64131-4517
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
313326
LA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
325879
LA
Other
Enumeration date
06/20/2019
Last updated
09/10/2025
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