Basic Information
| Provider Information | |||||||||
| NPI: | 1841259207 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BACHELOR | ||||||||
| FirstName: | ANGELA | ||||||||
| MiddleName: | T | ||||||||
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| Credential: | A.R.N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1657 | ||||||||
| Address2: | |||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 666011657 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852958108 | ||||||||
| FaxNumber: | 7852315991 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 SW COLLEGE AVE | ||||||||
| Address2: | |||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 666061684 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852339643 | ||||||||
| FaxNumber: | 7852331256 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2006 | ||||||||
| LastUpdateDate: | 03/15/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 45647 | KS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 161451 | 01 | KS | BCBS KANSAS | OTHER | 200316320A | 05 | KS | MEDICAID | P00217588 | 01 | KS | RAILROAD MEDICARE | OTHER |