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Individual

JESSICA MALCOLM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
20511 E TRINITY PL, BLUE SPRINGS, MO 64015-9501
(816) 622-2900
Mailing address
7200 W 72ND ST, OVERLAND PARK, KS 66204-1937

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
53-80900-102
KS

Other

Enumeration date
02/03/2022
Last updated
02/03/2022
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