MEDICARE: MRS. ANGELA LAUREN GENGELBACH APRN, FNP-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
1	363L00000X	Nurse Practitioner	53-79901-041	KS
2	363LP2300X	Primary Care Nurse Practitioner	2020022830	MO

General Provider Information

NPI Number	:	1598340762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANGELA LAUREN GENGELBACH APRN, FNP-C

Provider Business Mailing Address
First Line	:	9787 N CEDAR AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64157-6208
Country	:	US
Telephone Number	:	816-408-3717
Fax Number	:	816-429-9762

Provider Business Practice Location Address
First Line	:	9787 N CEDAR AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64157-6208
Country	:	US
Telephone Number	:	816-408-3717
Fax Number	:	816-429-9762

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

Provider Enumeration Date	:	03/10/2021
Last Update Date	:	12/18/2025

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