Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | 090489 | MO |
Y | 363LA2200X | Nurse Practitioner - Adult Health | 44758 | KS |
NPI | 1003903675 |
---|---|
Provider Name | Jill S Keast |
First Address | Kansas City, KS 66160-8501 |
Second Address | Kansas City, KS 66160-8500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 24/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100319810A | (05) | KS |
100319810C | (05) | KS |
1003903675 | (05) | MO |
160137 | BCBS KS OUTREACH CLINICS (01) | KS |
26354011 | BCBS KC (01) | |
S64846 | (02) |