Provider Demographics
NPI:1649077892
Name:ANGELL, HEATHER LYNN (RN)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:LYNN
Last Name:ANGELL
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4576 TUNDRA LN NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-2288
Mailing Address - Country:US
Mailing Address - Phone:507-319-8566
Mailing Address - Fax:
Practice Address - Street 1:4576 TUNDRA LN NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-2288
Practice Address - Country:US
Practice Address - Phone:507-319-8566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1524093163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse