Basic Information
| Provider Information | |||||||||
| NPI: | 1457691354 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CANGIANI | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | E. | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4505 NW FIELDING RD | ||||||||
| Address2: | |||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 666182651 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852700080 | ||||||||
| FaxNumber: | 7852700001 | ||||||||
| Practice Location | |||||||||
| Address1: | 4505 NW FIELDING RD | ||||||||
| Address2: | |||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 666182651 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852700080 | ||||||||
| FaxNumber: | 7852700001 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2013 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 13-105168 | KS | N | Nursing Service Providers | Registered Nurse | 363L00000X | 53-759393 | KS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 068002212 | 01 | KS | MEDICARE PTAN | OTHER | 201007310A | 05 | KS | MEDICAID |