Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 0431835 | KS |
Y | 111NI0900X | Internist | 0431835 | KS |
N | 207R00000X | Internist | 946203 | KS |
N | 111NI0900X | Internist | 946203 | KS |
NPI | 1003037615 |
---|---|
Provider Name | Jessica A Stone |
First Address | Shawnee, KS 66217-9414 |
Second Address | Shawnee, KS 66217-9414 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 29/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2004610400 | (05) | KS |
200461040C | (05) | KS |
200461040E | (05) | KS |