Provider Demographics
NPI:1720249881
Name:WOOD, ANGELA IRENE (RN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:IRENE
Last Name:WOOD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 E 23RD ST
Mailing Address - Street 2:STE 200
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-0800
Mailing Address - Country:US
Mailing Address - Phone:866-784-2329
Mailing Address - Fax:877-550-6600
Practice Address - Street 1:1005 E 23RD ST
Practice Address - Street 2:STE 200
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-0800
Practice Address - Country:US
Practice Address - Phone:866-784-2329
Practice Address - Fax:877-550-6600
Is Sole Proprietor?:No
Enumeration Date:2008-06-21
Last Update Date:2008-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000158151163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse