Provider Demographics
NPI:1225378805
Name:MANGOLD, RITA A (RN)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:A
Last Name:MANGOLD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
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Mailing Address - Street 1:901 E 104TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-4517
Mailing Address - Country:US
Mailing Address - Phone:816-502-8756
Mailing Address - Fax:816-932-9670
Practice Address - Street 1:5844 NW BARRY RD
Practice Address - Street 2:SUITE 300
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64154-1465
Practice Address - Country:US
Practice Address - Phone:816-880-6238
Practice Address - Fax:816-880-2770
Is Sole Proprietor?:No
Enumeration Date:2013-02-19
Last Update Date:2020-11-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2013006315363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health