Provider Demographics
NPI:1447734488
Name:KAISER, ANGELA NICOLE (CRNP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:NICOLE
Last Name:KAISER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:LOMBARDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 CLEMENTS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08007-1814
Mailing Address - Country:US
Mailing Address - Phone:565-478-0008
Mailing Address - Fax:856-547-1008
Practice Address - Street 1:600 CLEMENTS BRIDGE RD
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08007-1814
Practice Address - Country:US
Practice Address - Phone:565-478-0008
Practice Address - Fax:856-547-1008
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-15
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH450410163W00000X
PA645354163W00000X
OH023648363LF0000X
PASP019289363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse