Sample, Jennifer A

Sample, Jennifer A is an individual health care provider with primary practice located at 1104 Platte Falls Rd , Platte City MO 64079-7629. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Medical Toxicology, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Sample, Jennifer A can be contacted via phone (816) 665-1080.

Contact Information

Primary practice address
1104 Platte Falls Rd Platte City MO 64079-7629
Phone: (816) 665-1080
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Medical Toxicology 2080T0002X 110981 Missouri
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 110981 Missouri

Profile Details

NPI number 1912004342
LBN Legal business name Sample, Jennifer A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Dec 13th, 2019 - about 5 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 1912004342 NPPES
Missouri MEDICAID 204705701
Missouri MEDICAID 100347580A

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