Basic Information
| Provider Information | |||||||||
| NPI: | 1851880959 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | GENGLER | ||||||||
| FirstName: | TIMOTHY | ||||||||
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| NamePrefix: | MR. | ||||||||
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| Credential: | CRNA, RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11153 ROWLAND AVE | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 661097878 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8168202139 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3901 RAINBOW BLVD | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 66160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9135886670 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2018 | ||||||||
| LastUpdateDate: | 05/24/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 557582 | KS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.