Provider Demographics
NPI:1043021934
Name:THOMPSON, ANGEL R
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:R
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19275 E PEACEFUL ST
Mailing Address - Street 2:
Mailing Address - City:MAXWELL
Mailing Address - State:NE
Mailing Address - Zip Code:69151-1202
Mailing Address - Country:US
Mailing Address - Phone:308-529-3402
Mailing Address - Fax:
Practice Address - Street 1:4535 NORMAL BLVD STE 235
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-2891
Practice Address - Country:US
Practice Address - Phone:402-207-1050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-18
Last Update Date:2025-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker