Provider Demographics
NPI:1982320123
Name:LOUNCE, ANGEL ANITA (LPN)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:ANITA
Last Name:LOUNCE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8001 E 90TH TER
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64138-4164
Mailing Address - Country:US
Mailing Address - Phone:816-352-8422
Mailing Address - Fax:
Practice Address - Street 1:8001 E 90TH TER
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64138-4164
Practice Address - Country:US
Practice Address - Phone:816-352-8422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011038635164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO85-3777960Medicaid