Healthcare Provider Details

I. General information

NPI: 1609731116
Provider Name (Legal Business Name): MATTHEW JOSEPH MUNDEN RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13344 METCALF AVE
OVERLAND PARK KS
66213-2804
US

IV. Provider business mailing address

12224 CONNELL DR
OVERLAND PARK KS
66213-1673
US

V. Phone/Fax

Practice location:
  • Phone: 913-948-2020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number13111715121
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: