Provider Demographics
NPI:1194306795
Name:FROEHLER, JOHN (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:FROEHLER
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10841 GLEN ARBOR RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-4983
Mailing Address - Country:US
Mailing Address - Phone:816-941-2058
Mailing Address - Fax:
Practice Address - Street 1:10841 GLEN ARBOR RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-4983
Practice Address - Country:US
Practice Address - Phone:816-941-2058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-16
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020022860363L00000X, 363LF0000X
KS53-79589-031363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily