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Individual

ANGELA PENROSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
10302 W 60TH TER, SHAWNEE, KS 66203-3050
(816) 726-4212
Mailing address
10302 W 60TH TER, SHAWNEE, KS 66203-3050

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200538800A
KS
Enumeration date
04/28/2008
Last updated
04/28/2008
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