MEDICARE: ANGELA JEAN LEDDY CNA/MA

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	376K00000X	Nurse's Aide	55648	NE

General Provider Information

NPI Number	:	1073318242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA JEAN LEDDY CNA/MA

Provider Business Mailing Address
First Line	:	4449 HIGH ST
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68506-3364
Country	:	US
Telephone Number	:	402-805-1872
Fax Number	:

Provider Business Practice Location Address
First Line	:	4449 HIGH ST
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68506-3364
Country	:	US
Telephone Number	:	402-805-1872
Fax Number	:

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

Provider Enumeration Date	:	02/13/2025
Last Update Date	:	02/13/2025

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Directions to “ ANGELA JEAN LEDDY CNA/MA” Practice Location

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