Provider Demographics
NPI:1437775574
Name:IMEL, JENNIFER ANN (APRN)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ANN
Last Name:IMEL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MINNEOLA
Mailing Address - State:KS
Mailing Address - Zip Code:67865
Mailing Address - Country:US
Mailing Address - Phone:620-885-4202
Mailing Address - Fax:620-885-4205
Practice Address - Street 1:222 MAIN STREET
Practice Address - Street 2:
Practice Address - City:MINNEOLA
Practice Address - State:KS
Practice Address - Zip Code:67865
Practice Address - Country:US
Practice Address - Phone:620-885-4202
Practice Address - Fax:620-885-4205
Is Sole Proprietor?:No
Enumeration Date:2020-06-24
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-112791163W00000X
KS53-79600-122363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse