Provider Demographics
NPI:1285448969
Name:MCKEAN, ANGELA L
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:L
Last Name:MCKEAN
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 1:550 COUNTY ROAD 312
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:OH
Mailing Address - Zip Code:44811-9026
Mailing Address - Country:US
Mailing Address - Phone:419-217-7815
Mailing Address - Fax:
Practice Address - Street 1:550 COUNTY ROAD 312
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:OH
Practice Address - Zip Code:44811-9026
Practice Address - Country:US
Practice Address - Phone:419-217-7815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care