Individual
JEAN M STORK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
CENTER FOR CHILD HEALTH AND DEVELOPMENT, 3901 RAINBOW BLVD., MSN 4003, KANSAS CITY, KS 66160-0001
(913) 945-6677
(913) 588-8568
Mailing address
CENTER FOR CHILD HEALTH AND DEVELOPMENT, 3901 RAINBOW BLVD., MSN 4003, KANSAS CITY, KS 66160-0001
(913) 945-6677
(913) 588-8568
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1438
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200639390 A
—
KS
Enumeration date
01/13/2010
Last updated
08/08/2014
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