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General NPI Number Information
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NPI Number | 1861769721
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Entity Type | Individual
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Provider Name | KIRSTEN ANGELL
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Gender | Female
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Dates
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Enumeration Date | 11/21/2011
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Last Update Date | 02/28/2017
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Provider Practice Location Address
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Address Line | 279 EMMERAM RD
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City | ELLIS
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State | KS
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Zip | 67637-9229
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Country | US
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Telephone | 785-410-3599
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Fax | 785-726-2449
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Provider Business Mailing Address
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Address Line | 3639 COUNTY ROAD I
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City | GOVE
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State | KS
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Zip | 67736-6007
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Country | US
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Telephone | 785-410-3599
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Fax | 785-726-2449
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 1514
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License Number State | KS
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