=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336083807
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MS. ANGELA B HEMRY
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/16/2026
-----------------------------------------------------
Last Update Date | 04/16/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 824 VALIANT ST
-----------------------------------------------------
City | MIDDLETON
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83644-5981
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-296-3356
-----------------------------------------------------
Fax | 208-444-2199
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 824 VALIANT ST
-----------------------------------------------------
City | MIDDLETON
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83644-5981
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-296-3356
-----------------------------------------------------
Fax | 208-444-2199
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | ID
-----------------------------------------------------