Provider Demographics
NPI:1730478173
Name:SHUEY, ANGELLA DAWN (WHNP)
Entity Type:Individual
Prefix:
First Name:ANGELLA
Middle Name:DAWN
Last Name:SHUEY
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:ANGELLA
Other - Middle Name:
Other - Last Name:HALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:402 W JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-3407
Mailing Address - Country:US
Mailing Address - Phone:660-665-3555
Mailing Address - Fax:
Practice Address - Street 1:402 W JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-3407
Practice Address - Country:US
Practice Address - Phone:660-665-3555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011024996363LW0102X
MO147782363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health