Provider Demographics
NPI:1003852187
Name:NAGEL, KIMBERLY FOLEY (ARNP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:FOLEY
Last Name:NAGEL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:FOLEY
Other - Last Name:FOLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5701 W 119TH ST
Mailing Address - Street 2:SUITE 345
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209
Mailing Address - Country:US
Mailing Address - Phone:913-339-9046
Mailing Address - Fax:913-339-9018
Practice Address - Street 1:5701 W 119TH ST
Practice Address - Street 2:SUITE 345
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209
Practice Address - Country:US
Practice Address - Phone:913-339-9046
Practice Address - Fax:913-339-9018
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45263207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1003852187Medicaid
KSP00823846Medicare PIN
MOP01A00002Medicare PIN
KSM798976Medicare PIN