Provider Demographics
NPI:1780472183
Name:WAMBERG, ANGELA DEE
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:DEE
Last Name:WAMBERG
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 156
Mailing Address - Street 2:
Mailing Address - City:WAUSA
Mailing Address - State:NE
Mailing Address - Zip Code:68786-0156
Mailing Address - Country:US
Mailing Address - Phone:402-841-7750
Mailing Address - Fax:402-841-7750
Practice Address - Street 1:PO BOX 156
Practice Address - Street 2:
Practice Address - City:WAUSA
Practice Address - State:NE
Practice Address - Zip Code:68786-0156
Practice Address - Country:US
Practice Address - Phone:402-841-7750
Practice Address - Fax:402-841-7750
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide