Provider Demographics
NPI:1669152864
Name:LAUX, ANGELA
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:LAUX
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 1:114 LORETTA AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-2548
Mailing Address - Country:US
Mailing Address - Phone:937-797-1818
Mailing Address - Fax:
Practice Address - Street 1:114 LORETTA AVE APT 3
Practice Address - Street 2:
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324-2548
Practice Address - Country:US
Practice Address - Phone:937-797-1818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-21
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No171W00000XOther Service ProvidersContractor