Provider Demographics
NPI:1487808382
Name:MEYER, ANGELA RUTH (RN)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:RUTH
Last Name:MEYER
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:N16435 24TH AVE N
Mailing Address - Street 2:
Mailing Address - City:NEKOOSA
Mailing Address - State:WI
Mailing Address - Zip Code:54457-9407
Mailing Address - Country:US
Mailing Address - Phone:715-886-3255
Mailing Address - Fax:
Practice Address - Street 1:N16435 24TH AVE N
Practice Address - Street 2:
Practice Address - City:NEKOOSA
Practice Address - State:WI
Practice Address - Zip Code:54457-9407
Practice Address - Country:US
Practice Address - Phone:715-886-3255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI154919-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse