MEDICARE: ANGELA G MANN RN, CH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	175886-30	WI

General Provider Information

NPI Number	:	1376985796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA G MANN RN, CH

Provider Business Mailing Address
First Line	:	N7792 17TH AVE
Second Line	:
City	:	NEW LISBON
State	:	WI
Zip	:	53950-9696
Country	:	US
Telephone Number	:	608-547-4722
Fax Number	:

Provider Business Practice Location Address
First Line	:	N7792 17TH AVE
Second Line	:
City	:	NEW LISBON
State	:	WI
Zip	:	53950-9696
Country	:	US
Telephone Number	:	608-547-4722
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2013
Last Update Date	:	06/02/2026

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