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NPI Code Detail

MEDICARE: MRS. MISTY STAMBACH PA-C

MEDICARE: MRS. MISTY STAMBACH PA-C
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
1363AM0700XMedical Physician Assistant2013005694MO

General Provider Information

NPI Number : 1396085395
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MISTY STAMBACH PA-C
Provider Business Mailing Address
First Line : 4321 WASHINGTON ST STE 3000
Second Line :
City : KANSAS CITY
State : MO
Zip : 64111-5928
Country : US
Telephone Number : 816-932-3100
Fax Number : 816-932-6871
Provider Business Practice Location Address
First Line : 4321 WASHINGTON ST STE 3000
Second Line :
City : KANSAS CITY
State : MO
Zip : 64111-5928
Country : US
Telephone Number : 816-932-3100
Fax Number : 816-932-6871
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2013
Last Update Date : 02/01/2023

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Directions to “ MRS. MISTY STAMBACH PA-C” Practice Location

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