Provider Demographics
NPI:1518376003
Name:TERRELL, ANGELA (RN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:TERRELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 ASBURY RD
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-3042
Mailing Address - Country:US
Mailing Address - Phone:563-583-7357
Mailing Address - Fax:563-583-7026
Practice Address - Street 1:13011 120TH AVE
Practice Address - Street 2:
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-8662
Practice Address - Country:US
Practice Address - Phone:641-684-6692
Practice Address - Fax:641-684-7691
Is Sole Proprietor?:No
Enumeration Date:2014-08-08
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA131715163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health