Healthcare Provider Details

I. General information

NPI: 1942759444
Provider Name (Legal Business Name): ANN BARELA FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANN NGUYEN

II. Dates (important events)

Enumeration Date: 09/25/2016
Last Update Date: 01/04/2022
Certification Date: 08/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 NW STATE ROUTE 7 SUITE B
BLUE SPRINGS MO
64014-2726
US

IV. Provider business mailing address

4370 W 109TH ST STE 350
OVERLAND PARK KS
66211-1370
US

V. Phone/Fax

Practice location:
  • Phone: 816-229-8880
  • Fax:
Mailing address:
  • Phone: 816-941-0800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number53-77406-071
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2016034604
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: