Provider Demographics
NPI:1417579608
Name:BROWDER, ANGELA (NURSING/HOMECARE)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:
Last Name:BROWDER
Suffix:
Gender:F
Credentials:NURSING/HOMECARE
Other - Prefix:PROF
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:BROWDER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NURSING/HOMECARE
Mailing Address - Street 1:PO BOX 3436
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50316-0436
Mailing Address - Country:US
Mailing Address - Phone:515-988-2966
Mailing Address - Fax:
Practice Address - Street 1:2801 E 16TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50316-1842
Practice Address - Country:US
Practice Address - Phone:515-988-2966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-11
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide