Provider Demographics
NPI:1528392693
Name:DYRDAL, ANGELA M (RN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:DYRDAL
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 1:4001 W 89TH PL
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-3515
Mailing Address - Country:US
Mailing Address - Phone:303-427-4525
Mailing Address - Fax:
Practice Address - Street 1:4001 W 89TH PL
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-3515
Practice Address - Country:US
Practice Address - Phone:303-427-4525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO127895163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse