Provider Demographics
NPI:1154929081
Name:SIMIEN, ANGELA THERESA (LPN)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:THERESA
Last Name:SIMIEN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 S MARKET ST
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-5140
Mailing Address - Country:US
Mailing Address - Phone:337-948-0226
Mailing Address - Fax:
Practice Address - Street 1:220 S MARKET ST
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-5140
Practice Address - Country:US
Practice Address - Phone:337-948-0226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA250846164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse