Provider Demographics
NPI:1639979685
Name:GALVAN, ANGEL MAIRE (MA, LRT (PODIATRIC),)
Entity type:Individual
Prefix:MRS
First Name:ANGEL
Middle Name:MAIRE
Last Name:GALVAN
Suffix:
Gender:
Credentials:MA, LRT (PODIATRIC),
Other - Prefix:MRS
Other - First Name:ANGEL
Other - Middle Name:MAIRE
Other - Last Name:HENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LRT (PODIATRIC),
Mailing Address - Street 1:7905 L. ST STE 420
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127
Mailing Address - Country:US
Mailing Address - Phone:402-515-2654
Mailing Address - Fax:
Practice Address - Street 1:7905 L. ST STE 420
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127
Practice Address - Country:US
Practice Address - Phone:402-515-2654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant