Provider Demographics
NPI:1497724553
Name:VANDONGE, ANGELA (ARNP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:VANDONGE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8919 PARALLEL PKWY STE 121
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66112-1655
Mailing Address - Country:US
Mailing Address - Phone:913-596-7230
Mailing Address - Fax:913-596-7228
Practice Address - Street 1:8919 PARALLEL PKWY STE 121
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-1655
Practice Address - Country:US
Practice Address - Phone:913-596-7230
Practice Address - Fax:913-596-7228
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-86581-012363LF0000X
KS45552363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
161602Medicare ID - Type Unspecified
Q64352Medicare UPIN