1457565145 NPI number — MISS ANGELANA MARIE KREEGER MA, PLPC

Table of content: MISS ANGELANA MARIE KREEGER MA, PLPC (NPI 1457565145)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457565145 NPI number — MISS ANGELANA MARIE KREEGER MA, PLPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KREEGER
Provider First Name:
ANGELANA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
MA, PLPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457565145
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/11/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
900 E. LA HARPE ST.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KIRKSVILLE
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63501
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
660-665-1962
Provider Business Mailing Address Fax Number:
660-665-3989

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7 WESTOWNE
Provider Second Line Business Practice Location Address:
SUITE 403
Provider Business Practice Location Address City Name:
ST. CHARLES
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64068
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-407-1754
Provider Business Practice Location Address Fax Number:
816-407-1739
Provider Enumeration Date:
05/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  2005010425 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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