Provider Demographics
NPI:1962217174
Name:BOWERS, ANGELA SUE (DSP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:SUE
Last Name:BOWERS
Suffix:
Gender:F
Credentials:DSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 6TH AVE TRLR 4
Mailing Address - Street 2:
Mailing Address - City:HOLDREGE
Mailing Address - State:NE
Mailing Address - Zip Code:68949-3268
Mailing Address - Country:US
Mailing Address - Phone:308-233-7258
Mailing Address - Fax:
Practice Address - Street 1:1709 W 39TH ST
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-8230
Practice Address - Country:US
Practice Address - Phone:308-234-6834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist