Provider Demographics
NPI:1265261150
Name:MCCLENDON, JASMINE (CRNA)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:MCCLENDON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12212 E 57TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64133-3520
Mailing Address - Country:US
Mailing Address - Phone:816-262-4310
Mailing Address - Fax:
Practice Address - Street 1:9100 W 74TH ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE MISSION
Practice Address - State:KS
Practice Address - Zip Code:66204-4004
Practice Address - Country:US
Practice Address - Phone:913-632-2230
Practice Address - Fax:913-632-2297
Is Sole Proprietor?:No
Enumeration Date:2024-07-29
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS558295367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered