Provider Demographics
NPI:1508308289
Name:NAUJOKS, ANGELA MARIE (LIMHP, PCP, MED AIDE)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:NAUJOKS
Suffix:
Gender:F
Credentials:LIMHP, PCP, MED AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 45173
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68145-0173
Mailing Address - Country:US
Mailing Address - Phone:402-401-4027
Mailing Address - Fax:402-827-6731
Practice Address - Street 1:595 N 155TH PLZ
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-3775
Practice Address - Country:US
Practice Address - Phone:402-401-4027
Practice Address - Fax:402-827-6731
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-10
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1750101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026799500Medicaid