Healthcare Provider Details

I. General information

NPI: 1629615240
Provider Name (Legal Business Name): ANGELA CLOUD DNP, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2019
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 IOWA ST
LAWRENCE KS
66044-1838
US

IV. Provider business mailing address

1015 IOWA ST
LAWRENCE KS
66044-1838
US

V. Phone/Fax

Practice location:
  • Phone: 785-505-5671
  • Fax: 785-505-5336
Mailing address:
  • Phone: 785-505-5671
  • Fax: 785-505-5336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-79800-011
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number116180
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: