Provider Demographics
NPI:1316807928
Name:GARDNER-LOLLAS, JILL ELIZABETH (PMHNP)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:ELIZABETH
Last Name:GARDNER-LOLLAS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8005 W 110TH ST STE 204
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2619
Mailing Address - Country:US
Mailing Address - Phone:913-333-2983
Mailing Address - Fax:
Practice Address - Street 1:8005 W 110TH ST STE 204
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2619
Practice Address - Country:US
Practice Address - Phone:913-333-2983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-15
Last Update Date:2025-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-84897-051363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health