Individual
JENNIFER MARIE HACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2820 E ROCK HAVEN RD STE 100, HARRISONVILLE, MO 64701-4413
(816) 380-3582
(816) 380-6964
Mailing address
1501 SW FAIRFAX RD, LEES SUMMIT, MO 64083-4501
(417) 294-2646
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2019038340
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972158426
—
MO
Enumeration date
08/01/2019
Last updated
03/08/2021
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