Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 01076020A | IN |
N | 208600000X | Surgeon | 01076020A | IN |
N | 2086S0102X | Surgical Critical Care | 01076020A | IN |
N | 2086S0127X | Trauma Surgeon | 036.121342 | IL |
Y | 2086S0127X | Trauma Surgeon | 04-45624 | KS |
NPI | 1306024260 |
---|---|
Provider Name | Jennifer Leigh Hartwell |
First Address | Kansas City, KS 66160-4959 |
Second Address | Kansas City, KS 66160-1239 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2008 |
Last Update Date | 20/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201342140 | (05) | IN |
3156669 | (05) | OH |