Provider Demographics
NPI:1154967768
Name:REDA, ANGELA M (RN)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:REDA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:M
Other - Last Name:DAVIDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:108 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:MA
Mailing Address - Zip Code:02766-1248
Mailing Address - Country:US
Mailing Address - Phone:508-285-9400
Mailing Address - Fax:508-285-4520
Practice Address - Street 1:108 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:MA
Practice Address - Zip Code:02766-1248
Practice Address - Country:US
Practice Address - Phone:508-285-9400
Practice Address - Fax:508-285-4520
Is Sole Proprietor?:No
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN209999163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse