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Contact Information

JENNIFER A SAMPLE, MD
1104 PLATTE FALLS RD
PLATTE CITY, MO64079-7629
 Phone: 816-665-1080
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Medical Toxicology

2080T0002X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for JENNIFER A SAMPLE · (Female)

NPI Number 1912004342
Status Active
Credentials MD
Entity Individual
Enumeration date 09/20/2006
Last updated 12/13/2019 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 110981
  • KS Medicaid 100347580A
  • MO Medicaid 204705701
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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