Provider Demographics
NPI:1871311589
Name:KREGLOW, ANGELA LEE
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:LEE
Last Name:KREGLOW
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 1:12147 STATE ROUTE 55
Mailing Address - Street 2:
Mailing Address - City:SAINT PARIS
Mailing Address - State:OH
Mailing Address - Zip Code:43072-9518
Mailing Address - Country:US
Mailing Address - Phone:419-308-0119
Mailing Address - Fax:
Practice Address - Street 1:12147 STATE ROUTE 55
Practice Address - Street 2:
Practice Address - City:SAINT PARIS
Practice Address - State:OH
Practice Address - Zip Code:43072-9518
Practice Address - Country:US
Practice Address - Phone:419-308-0119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty