Provider Demographics
NPI:1235723909
Name:RAMSEY, DEANGELO (PCA)
Entity Type:Individual
Prefix:MR
First Name:DEANGELO
Middle Name:
Last Name:RAMSEY
Suffix:
Gender:M
Credentials:PCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3916 GUSTINE AVE # A
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63116-3526
Mailing Address - Country:US
Mailing Address - Phone:314-745-3502
Mailing Address - Fax:
Practice Address - Street 1:3916 GUSTINE AVE # A
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63116-3526
Practice Address - Country:US
Practice Address - Phone:314-745-3502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty