Healthcare Provider Details

I. General information

NPI: 1174935530
Provider Name (Legal Business Name): ANGELA DREBES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2014
Last Update Date: 05/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 COMMUNICATION DR
HANNIBAL MO
63401-3670
US

IV. Provider business mailing address

900 E LAHARPE ST
KIRKSVILLE MO
63501-4520
US

V. Phone/Fax

Practice location:
  • Phone: 573-795-7342
  • Fax: 573-248-3080
Mailing address:
  • Phone: 660-665-1962
  • Fax: 660-665-3989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2013004902
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: