Healthcare Provider Details

I. General information

NPI: 1598748386
Provider Name (Legal Business Name): ANGELA M RESCH PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2005
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 S 4TH ST STE 200
LEAVENWORTH KS
66048
US

IV. Provider business mailing address

3550 S 4TH ST STE 200
LEAVENWORTH KS
66048-5009
US

V. Phone/Fax

Practice location:
  • Phone: 913-680-6442
  • Fax: 913-680-6425
Mailing address:
  • Phone: 913-680-6442
  • Fax: 913-351-1346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1500738
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number1047745
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: