Provider Demographics
NPI:1265230585
Name:STRUB, ANGEL
Entity type:Individual
Prefix:MISS
First Name:ANGEL
Middle Name:
Last Name:STRUB
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 W REBECCA LN
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68528-1122
Mailing Address - Country:US
Mailing Address - Phone:402-525-0467
Mailing Address - Fax:
Practice Address - Street 1:4300 W REBECCA LN
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68528-1122
Practice Address - Country:US
Practice Address - Phone:402-525-0467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty