Provider Demographics
NPI:1700188976
Name:REESE, ANGELA (LPN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:REESE
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 1:3525 VILLA CASA CT
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-3747
Mailing Address - Country:US
Mailing Address - Phone:216-315-4435
Mailing Address - Fax:
Practice Address - Street 1:3525 VILLA CASA CT
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:OH
Practice Address - Zip Code:44212-3747
Practice Address - Country:US
Practice Address - Phone:216-315-4435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-22
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.139196164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse