Provider Demographics
NPI:1699593632
Name:PEOPLES, ANGEL DENISE (CNA)
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:DENISE
Last Name:PEOPLES
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:MS
Other - First Name:ANGEL
Other - Middle Name:DENISE
Other - Last Name:PEOPLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:214 MISKELL BLVD # A
Mailing Address - Street 2:
Mailing Address - City:CAHOKIA
Mailing Address - State:IL
Mailing Address - Zip Code:62206-2116
Mailing Address - Country:US
Mailing Address - Phone:314-240-8607
Mailing Address - Fax:
Practice Address - Street 1:10016 OFFICE CENTER AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-1468
Practice Address - Country:US
Practice Address - Phone:636-519-0881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO134968376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide