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NPI Code Detail

MEDICARE: ANGELA B HARDEN NP

MEDICARE: ANGELA B HARDEN NP
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
1363L00000XNurse Practitioner082514MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2159089OTHERBLUE CROSS OF MO
3431560263OTHERTRICARE WEST

General Provider Information

NPI Number : 1275634297
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA B HARDEN NP
Provider Business Mailing Address
First Line : PO BOX 802843
Second Line :
City : KANSAS CITY
State : MO
Zip : 64180-2843
Country : US
Telephone Number : 417-269-5712
Fax Number : 417-269-7567
Provider Business Practice Location Address
First Line : 3443 S NATIONAL AVE
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65807-7308
Country : US
Telephone Number : 417-269-2000
Fax Number : 417-269-2038
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2006
Last Update Date : 08/06/2020

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