Deselms, Jason

Deselms, Jason is an individual health care provider with primary practice located at 57950 Leavenworth St , Mcconnell Afb KS 67221-3505. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Deselms, Jason can be contacted via phone (316) 759-5095.

Contact Information

Primary practice address
57950 Leavenworth St Mcconnell Afb KS 67221-3505
Phone: (316) 759-5095
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 1312 Kansas

Profile Details

NPI number 1518909357
LBN Legal business name Deselms, Jason
Credentials LP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated May 4th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518909357 NPPES
Kansas Other 389904 BLUE CROSS BLUE SHIELD

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