Provider Demographics
NPI:1477356194
Name:ROMAN, ANGELA JOY
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:JOY
Last Name:ROMAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:JOY
Other - Last Name:RINEHART/JIRSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:115 COMET CT
Mailing Address - Street 2:
Mailing Address - City:ALDA
Mailing Address - State:NE
Mailing Address - Zip Code:68810-9748
Mailing Address - Country:US
Mailing Address - Phone:605-478-0213
Mailing Address - Fax:
Practice Address - Street 1:2208 N WEBB RD UNIT 4
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-1756
Practice Address - Country:US
Practice Address - Phone:308-381-1690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant