MEDICARE: PAM HIRANSOMBOON-VOGEL FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	78243	KS

General Provider Information

NPI Number	:	1063790673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAM HIRANSOMBOON-VOGEL FNP-BC

Provider Business Mailing Address
First Line	:	4000 CAMBRIDGE STREET DELP 2060 MAIL STOP 2018
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-0001
Country	:	US
Telephone Number	:	816-588-3807
Fax Number	:

Provider Business Practice Location Address
First Line	:	4000 CAMBRIDGE STREET DELP 2060 MAIL STOP 2018
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-5741
Country	:	US
Telephone Number	:	816-588-3807
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2011
Last Update Date	:	04/20/2022

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