Provider Demographics
NPI:1275634297
Name:HARDEN, ANGELA B (NP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:B
Last Name:HARDEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:B
Other - Last Name:SLOAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 802843
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-2843
Mailing Address - Country:US
Mailing Address - Phone:417-269-5712
Mailing Address - Fax:417-269-7567
Practice Address - Street 1:3443 S NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-7308
Practice Address - Country:US
Practice Address - Phone:417-269-2000
Practice Address - Fax:417-269-2038
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO082514363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO424962207Medicaid
159089OtherBLUE CROSS OF MO
431560263OtherTRICARE WEST
MO424962207Medicaid