Provider Demographics
NPI:1487242921
Name:NEDEFF, ANGELA JOAN (RN, BSN NBC-HWC)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:JOAN
Last Name:NEDEFF
Suffix:
Gender:F
Credentials:RN, BSN NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6165 MUNGER RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-1145
Mailing Address - Country:US
Mailing Address - Phone:937-672-6733
Mailing Address - Fax:
Practice Address - Street 1:6165 MUNGER RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-1145
Practice Address - Country:US
Practice Address - Phone:937-672-6733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-08
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.212204163W00000X
171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No163W00000XNursing Service ProvidersRegistered Nurse