Provider Demographics
NPI:1912283425
Name:FENZEL, LINDSEY MARIE (APRN)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:MARIE
Last Name:FENZEL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:MARIE
Other - Last Name:RUMMEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11300 CORPORATE AVE
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219-1374
Mailing Address - Country:US
Mailing Address - Phone:913-574-2800
Mailing Address - Fax:913-574-2336
Practice Address - Street 1:4881 NE GOODVIEW CIR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064
Practice Address - Country:US
Practice Address - Phone:913-574-2350
Practice Address - Fax:913-574-2413
Is Sole Proprietor?:No
Enumeration Date:2011-10-28
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012000115163W00000X
KS116650163W00000X
KS75542363LA2200X
NE111305363LA2200X
MO2011039080363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200851140AMedicaid
MO1912283425Medicaid
KS200851140AMedicaid
MOMA3347036Medicare PIN