Jennifer L Othmer, CNS

Individual provider Active NPI Clinical Nurse Specialist · Kansas City, MO

NPI 1770528283 · NPPES record last updated Feb 20, 2008

Key facts

NPI
1770528283
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Nurse Specialist 364S00000X
License
2005027490 (MO)
Practice address
4401 Wornall Rd
Kansas City, MO 64111-3220
Phone
(816) 932-2179
NPI assigned
Jun 18, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
2005027490MOMDClinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Lukes Advanced Practice Nurse Past Accepting new patients
Saint Lukes Physician Group II LLC Past Accepting new patients
St Lukes Hospital of Kansas City Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X 2005027490 MO Yes

Addresses

Primary practice location

4401 Wornall Rd
Kansas City, MO 64111-3220

Mailing address

PO Box 931168
Kansas City, MO 64193-0001
Phone (816) 461-8288

Other names

  • Jennifer L Matukaitis Former name

Other providers in Kansas City, MO

All providers in Kansas City, MO · Clinical Nurse Specialist in Missouri

Sources for this page

Verify at the official NPI Registry.