Basic Information
| Provider Information | |||||||||
| NPI: | 1396164158 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NJUGUNA | ||||||||
| FirstName: | JOYCE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6000 LAMAR AVE | ||||||||
| Address2: | |||||||||
| City: | MISSION | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662023299 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9138264200 | ||||||||
| FaxNumber: | 9138261589 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 E 24TH ST UNIT OFFICE53 | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641082776 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8164043710 | ||||||||
| FaxNumber: | 8164043611 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2014 | ||||||||
| LastUpdateDate: | 05/28/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0809X | 110787 | KS | N | Nursing Service Providers | Registered Nurse | Psych/Mental Health, Adult | 363LP0808X | 79080 | KS | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 363LP0808X | 2019043528 | MO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
ID Information
| ID | Type | State | Issuer | Description | 420083088 | 05 | MO | MEDICAID |