Provider Demographics
NPI:1417769670
Name:BEAR, ANGELA (CNA)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:BEAR
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:K
Other - Last Name:HINE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNA
Mailing Address - Street 1:16909 LAKESIDE HILLS PLZ STE 114
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-4652
Mailing Address - Country:US
Mailing Address - Phone:402-932-2211
Mailing Address - Fax:402-932-9002
Practice Address - Street 1:16909 LAKESIDE HILLS PLZ STE 114
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-4652
Practice Address - Country:US
Practice Address - Phone:402-932-2211
Practice Address - Fax:402-932-9002
Is Sole Proprietor?:No
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE74009374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide