Provider Demographics
NPI:1275332660
Name:JANES, MICHELLE LAUREN (CPNP-PC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LAUREN
Last Name:JANES
Suffix:
Gender:
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:LAUREN
Other - Last Name:PINKELMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2401 GILLHAM RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-4619
Mailing Address - Country:US
Mailing Address - Phone:816-234-3000
Mailing Address - Fax:
Practice Address - Street 1:2401 GILLHAM RD
Practice Address - Street 2:PROVIDER ENROLLMENT DEPT
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-4619
Practice Address - Country:US
Practice Address - Phone:816-701-5200
Practice Address - Fax:816-302-9939
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-84128-071363LP0200X
MO2025006756363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics