Provider Demographics
NPI:1871883330
Name:SCHWABE, ANGALA RAYE (CRNA)
Entity type:Individual
Prefix:
First Name:ANGALA
Middle Name:RAYE
Last Name:SCHWABE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ANGALA
Other - Middle Name:RAYE
Other - Last Name:SWANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:400 10TH ST E
Mailing Address - Street 2:
Mailing Address - City:WACONIA
Mailing Address - State:MN
Mailing Address - Zip Code:55387-4552
Mailing Address - Country:US
Mailing Address - Phone:888-209-0305
Mailing Address - Fax:952-442-3620
Practice Address - Street 1:4405 HAMILTON BLVD
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51104-1140
Practice Address - Country:US
Practice Address - Phone:712-239-3937
Practice Address - Fax:952-442-3620
Is Sole Proprietor?:No
Enumeration Date:2011-04-18
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA106482367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered