Provider Demographics
NPI:1811394422
Name:INTERIANO, ANGELA J (APRN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:J
Last Name:INTERIANO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:J
Other - Last Name:FOLSOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:4000 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-8501
Mailing Address - Country:US
Mailing Address - Phone:913-588-3035
Mailing Address - Fax:913-588-6765
Practice Address - Street 1:4000 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-8501
Practice Address - Country:US
Practice Address - Phone:913-588-3035
Practice Address - Fax:913-588-6765
Is Sole Proprietor?:No
Enumeration Date:2014-11-25
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014042052363LA2200X
KS76499363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2014042052OtherMISSOURI DIVISION OF PROFESSIONAL REGISTRATION
KS53-76499-121OtherKANSAS STATE BOARD OF NURSING