Provider Demographics
NPI:1588417034
Name:PIKE, ANGELA JO
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:JO
Last Name:PIKE
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 1:156 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SEBEWAING
Mailing Address - State:MI
Mailing Address - Zip Code:48759-1337
Mailing Address - Country:US
Mailing Address - Phone:989-883-2057
Mailing Address - Fax:989-883-3520
Practice Address - Street 1:156 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SEBEWAING
Practice Address - State:MI
Practice Address - Zip Code:48759-1337
Practice Address - Country:US
Practice Address - Phone:989-883-2057
Practice Address - Fax:989-883-3520
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health