Theis, Jennifer K.

Theis, Jennifer K. is an individual health care provider with primary practice located at 3401 Mcintosh Cir Ste 100 , Joplin MO 64804-3651. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Theis, Jennifer K. can be contacted via phone (417) 347-7200.

Contact Information

Primary practice address
3401 Mcintosh Cir Ste 100 Joplin MO 64804-3651
Phone: (417) 347-7200
Fax: (417) 347-7236
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 142538 Missouri

Profile Details

NPI number 1639106560
LBN Legal business name Theis, Jennifer K.
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2006
Last updated Mar 19th, 2024 - about 2 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 1639106560 NPPES
Oklahoma MEDICAID 100091520A
Oklahoma Other 148311
Oklahoma MEDICAID 425136306
Oklahoma Other 500014242
Oklahoma MEDICAID 100380720A

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