Provider Demographics
NPI:1235552977
Name:DAMGAR, RONDA SUE (APRN)
Entity Type:Individual
Prefix:
First Name:RONDA
Middle Name:SUE
Last Name:DAMGAR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 N RIVERSIDE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64507-2553
Mailing Address - Country:US
Mailing Address - Phone:816-271-6666
Mailing Address - Fax:816-271-1300
Practice Address - Street 1:802 N RIVERSIDE RD STE 200
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64507-2553
Practice Address - Country:US
Practice Address - Phone:816-271-6666
Practice Address - Fax:816-271-1300
Is Sole Proprietor?:No
Enumeration Date:2014-01-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2014000690363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1235552977Medicaid
KS201090830AMedicaid
MOP01308933OtherRR MEDICARE
KS201090830AMedicaid