Healthcare Provider Details

I. General information

NPI: 1699195495
Provider Name (Legal Business Name): ANGELA MARIE YEAPLES LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2014
Last Update Date: 04/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6340 STUMPH RD 416
PARMA HEIGHTS OH
44130-2905
US

IV. Provider business mailing address

6340 STUMPH RD 416
PARMA HEIGHTS OH
44130-2905
US

V. Phone/Fax

Practice location:
  • Phone: 440-420-8228
  • Fax:
Mailing address:
  • Phone: 440-420-8228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN116677
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: