Provider Demographics
NPI:1831205046
Name:DAVIES, ANGELA K (APRN)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:K
Last Name:DAVIES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:K
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:555 S 70TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2462
Mailing Address - Country:US
Mailing Address - Phone:402-219-7878
Mailing Address - Fax:402-219-7431
Practice Address - Street 1:7441 O ST STE 304
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2466
Practice Address - Country:US
Practice Address - Phone:402-484-5600
Practice Address - Fax:402-484-5630
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110574363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q47830Medicare UPIN