Provider Demographics
NPI:1225665714
Name:MERIDA, ANGELA (CNA)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:MERIDA
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 W 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75110-6341
Mailing Address - Country:US
Mailing Address - Phone:214-708-1912
Mailing Address - Fax:
Practice Address - Street 1:1404 W 12TH AVE
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-6341
Practice Address - Country:US
Practice Address - Phone:214-708-1912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-24
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA0000071353376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty