Basic Information
| Provider Information | |||||||||
| NPI: | 1316485444 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PRICE | ||||||||
| FirstName: | ANGELA | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | APRN-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1301 W 12TH AVE STE 401 | ||||||||
| Address2: | |||||||||
| City: | EMPORIA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 668012591 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6203432900 | ||||||||
| FaxNumber: | 6203423672 | ||||||||
| Practice Location | |||||||||
| Address1: | 1301 W 12TH AVE STE 401 | ||||||||
| Address2: | |||||||||
| City: | EMPORIA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 668012591 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6203432900 | ||||||||
| FaxNumber: | 6203423672 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2017 | ||||||||
| LastUpdateDate: | 09/16/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 53-77566 | KS | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LF0000X | TMP-154256 | KS | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | 53-77566 | KS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.