Provider Demographics
NPI:1417430273
Name:KLUTE, ANGELA (LPN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:KLUTE
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 1:458 5TH ST
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:NE
Mailing Address - Zip Code:68843-9211
Mailing Address - Country:US
Mailing Address - Phone:402-725-3116
Mailing Address - Fax:
Practice Address - Street 1:458 5TH ST
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:NE
Practice Address - Zip Code:68843-9211
Practice Address - Country:US
Practice Address - Phone:402-725-3116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-07
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE19011164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE19011OtherLPN