Provider Demographics
NPI:1932580180
Name:YACKEL, ANGELICA LEE (APRN, CNP)
Entity Type:Individual
Prefix:
First Name:ANGELICA
Middle Name:LEE
Last Name:YACKEL
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:ANGELICA
Other - Middle Name:LEE
Other - Last Name:MATTHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1880 N FRONTAGE RD
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MN
Mailing Address - Zip Code:55033-2687
Mailing Address - Country:US
Mailing Address - Phone:651-438-1800
Mailing Address - Fax:
Practice Address - Street 1:1 N COLLEGE ST
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55057-4044
Practice Address - Country:US
Practice Address - Phone:507-222-4080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-13
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCNP3909363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner