Provider Demographics
NPI:1144032848
Name:FLETCHER, ANGELA
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:FLETCHER
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 1:85596 516TH AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:NE
Mailing Address - Zip Code:68726-5338
Mailing Address - Country:US
Mailing Address - Phone:402-841-5706
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 85
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:NE
Practice Address - Zip Code:68726-0085
Practice Address - Country:US
Practice Address - Phone:402-841-5706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-21
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM3000XAmbulatory Health Care FacilitiesClinic/CenterMedically Fragile Infants and Children Day Care