Provider Demographics
NPI:1437824323
Name:REYNOLDS, ANGELA MARIA (RN, BSN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIA
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4845 CURTIS AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-1300
Mailing Address - Country:US
Mailing Address - Phone:531-215-9108
Mailing Address - Fax:
Practice Address - Street 1:4845 CURTIS AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104-1300
Practice Address - Country:US
Practice Address - Phone:531-215-9108
Practice Address - Fax:531-299-2198
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE86492163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool