Provider Demographics
NPI:1770236994
Name:SISEL, ANGELA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:
Last Name:SISEL
Suffix:
Gender:F
Credentials:LPN
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 36
Mailing Address - Street 2:
Mailing Address - City:BRAINARD
Mailing Address - State:NE
Mailing Address - Zip Code:68626-0036
Mailing Address - Country:US
Mailing Address - Phone:402-545-2081
Mailing Address - Fax:402-545-2023
Practice Address - Street 1:212 S MADISON ST
Practice Address - Street 2:
Practice Address - City:BRAINARD
Practice Address - State:NE
Practice Address - Zip Code:68626-3515
Practice Address - Country:US
Practice Address - Phone:402-545-2081
Practice Address - Fax:402-545-2023
Is Sole Proprietor?:No
Enumeration Date:2022-01-28
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10401164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE470466022Medicaid