Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 2012004797 | MO |
N | 2080P0204X | Pediatric Emergency Doctor | 2012004797 | MO |
NPI | 1255652798 |
---|---|
Provider Name | Mrs. Amy Michelle D'angelo |
First Address | Kansas City, MO 64108-4619 |
Second Address | Kansas City, MO 64108-4619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2010 |
Last Update Date | 27/01/2022 |