Provider Demographics
NPI:1164718383
Name:DEAL, ANGELA J (LPN)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:J
Last Name:DEAL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3721 S GIBRALTAR ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-3944
Mailing Address - Country:US
Mailing Address - Phone:720-690-2509
Mailing Address - Fax:
Practice Address - Street 1:3721 S GIBRALTAR ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-3944
Practice Address - Country:US
Practice Address - Phone:720-690-2509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO43454164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse