Provider Demographics
NPI:1043424468
Name:WEBER, ANGELA ROSE (RN, NP)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:ROSE
Last Name:WEBER
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8270 MAPLE GROVE RD
Mailing Address - Street 2:
Mailing Address - City:MINDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48456-9798
Mailing Address - Country:US
Mailing Address - Phone:989-864-3843
Mailing Address - Fax:
Practice Address - Street 1:2254 E MAIN ST
Practice Address - Street 2:
Practice Address - City:UBLY
Practice Address - State:MI
Practice Address - Zip Code:48475-9566
Practice Address - Country:US
Practice Address - Phone:989-658-9191
Practice Address - Fax:989-658-2231
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704225120163W00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse