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General NPI Number Information
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NPI Number | 1265073209
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Entity Type | Individual
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Provider Name | ANGELA LOUISE RODIEK MSN
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Gender | Female
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Dates
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Enumeration Date | 10/01/2019
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 200 MCGEE RD
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City | ANDERSON
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State | SC
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Zip | 29625-2104
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Country | US
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Telephone | 864-260-2220
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Fax |
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Provider Business Mailing Address
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Address Line | 1 LINWA BLVD
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City | ANDERSON
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State | SC
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Zip | 29621-4486
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Country | US
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Telephone | 303-437-0167
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 25617
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN.0995102-NP
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License Number State | CO
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