Healthcare Provider Details

I. General information

NPI: 1598340762
Provider Name (Legal Business Name): ANGELA LAUREN GENGELBACH APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2021
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9787 N CEDAR AVE
KANSAS CITY MO
64157-6208
US

IV. Provider business mailing address

9787 N CEDAR AVE
KANSAS CITY MO
64157-6208
US

V. Phone/Fax

Practice location:
  • Phone: 816-408-3717
  • Fax: 816-429-9762
Mailing address:
  • Phone: 816-408-3717
  • Fax: 816-429-9762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number53-79901-041
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number2020022830
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: