Provider Demographics
NPI:1316430853
Name:VIEYRA, ANGIE
Entity type:Individual
Prefix:
First Name:ANGIE
Middle Name:
Last Name:VIEYRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANGIE
Other - Middle Name:
Other - Last Name:MORENO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4111 4TH AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-2883
Mailing Address - Country:US
Mailing Address - Phone:308-237-1102
Mailing Address - Fax:308-234-5712
Practice Address - Street 1:4111 4TH AVE STE 2
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-2883
Practice Address - Country:US
Practice Address - Phone:308-237-1102
Practice Address - Fax:308-234-5712
Is Sole Proprietor?:No
Enumeration Date:2018-06-09
Last Update Date:2018-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist