Humble, Jessilyn Ranae

Humble, Jessilyn Ranae is an individual health care provider with primary practice located at 2711 S Rouse St Ste B , Pittsburg KS 66762-6621. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Humble, Jessilyn Ranae can be contacted via phone (620) 235-7612.

Contact Information

Primary practice address
2711 S Rouse St Ste B Pittsburg KS 66762-6621
Fax: (620) 235-7613
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 04-38113 Kansas

Profile Details

NPI number 1740541234
LBN Legal business name Humble, Jessilyn Ranae
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2012
Last updated Jun 18th, 2019 - about 6 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 1740541234 NPPES
Kansas MEDICAID 201118970A

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