Provider Demographics
NPI:1366295743
Name:FELDMAN, ANGELA LYNN
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:LYNN
Last Name:FELDMAN
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 1:920 MUSKEGON AVE NW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49504-4442
Mailing Address - Country:US
Mailing Address - Phone:616-323-4257
Mailing Address - Fax:
Practice Address - Street 1:33 DALE ST NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49505-4613
Practice Address - Country:US
Practice Address - Phone:616-323-4257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide