Provider Demographics
NPI:1154780401
Name:SAWYER, ANGEL RHUNELL
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:RHUNELL
Last Name:SAWYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3459 GIBRATER HEIGHTS
Mailing Address - Street 2:05
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43609
Mailing Address - Country:US
Mailing Address - Phone:567-322-7753
Mailing Address - Fax:
Practice Address - Street 1:3459 GIBRALTER HEIGHTS DR
Practice Address - Street 2:APT 05
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43609
Practice Address - Country:US
Practice Address - Phone:567-322-7753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-15
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH322237921013374U00000X
MIMI000010498376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No374U00000XNursing Service Related ProvidersHome Health Aide