Provider Demographics
NPI:1376603258
Name:D'ANGIOLILLO, CINDY M (RN)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:M
Last Name:D'ANGIOLILLO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:M
Other - Last Name:ERTLE (HILLS)
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 579
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97339-0579
Mailing Address - Country:US
Mailing Address - Phone:541-766-6835
Mailing Address - Fax:541-766-6186
Practice Address - Street 1:530 NW 27TH ST
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-5223
Practice Address - Country:US
Practice Address - Phone:541-766-6835
Practice Address - Fax:541-766-6186
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR083039027RN163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR083039027RNOtherREGISTERED NURSE
OR1019872OtherTEACHER STAND. & PRACTICE