Provider Demographics
NPI:1386616845
Name:VOOS, JENNIFER L (PA)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:L
Last Name:VOOS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 247
Mailing Address - Street 2:
Mailing Address - City:SABETHA
Mailing Address - State:KS
Mailing Address - Zip Code:66534-0247
Mailing Address - Country:US
Mailing Address - Phone:785-284-2141
Mailing Address - Fax:785-284-0022
Practice Address - Street 1:1115 MAIN ST
Practice Address - Street 2:
Practice Address - City:SABETHA
Practice Address - State:KS
Practice Address - Zip Code:66534-1832
Practice Address - Country:US
Practice Address - Phone:785-284-2141
Practice Address - Fax:785-284-0022
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1500741363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
P95826Medicare UPIN