1861610032 NPI number — ANGELA M MCAFEE CRNA

Table of content: ANGELA M MCAFEE CRNA (NPI 1861610032)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861610032 NPI number — ANGELA M MCAFEE CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCAFEE
Provider First Name:
ANGELA
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HARVEY
Provider Other First Name:
ANGELA
Provider Other Middle Name:
M
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CRNA
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1861610032
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/07/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
18710 GRAND HARBOR PT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONTGOMERY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77356-4951
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-680-1710
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18710 GRAND HARBOR PT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONTGOMERY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77356-4951
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-680-1710
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/23/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  1310 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 163W00000X , with the licence number: 68644 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367500000X , with the licence number: AP128042 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0001244070 . This is a "VIRGINIA BOARD OF NURSING" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 68644 . This is a "RN" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 1310 . This is a "APRN" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: R208529 . This is a "MARYLAND BOARD OF NURSING" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 0024170854 . This is a "VIRGINIA BOARD OF NURSING" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: AP128042 . This is a "NURSE ANESTHETIST/APRN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 628615 . This is a "TEXAS RN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".