Provider Demographics
NPI:1194983908
Name:FOHNER, ANGELA L
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:L
Last Name:FOHNER
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 1:287 LOCKERT CT
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44311-2121
Mailing Address - Country:US
Mailing Address - Phone:330-459-3043
Mailing Address - Fax:
Practice Address - Street 1:287 LOCKERT CT
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44311-2121
Practice Address - Country:US
Practice Address - Phone:330-459-3043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2366096Medicaid