Active NPI
Angel Fay Nadeau, RN
- Registered Nurse
- Jackson, MI
National Provider Identifier
1144792771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 4704306197
- Practice address
- 1200 N West Ave
Jackson, MI 49202-2179 - Phone
- (517) 796-4540
- Fax
- (517) 796-4517
- NPI assigned
- Dec 20, 2018
- Last updated
- Dec 20, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 4704306197 | MI | Primary |
Addresses
Primary practice location
1200 N West Ave
Jackson, MI 49202-2179
Mailing address
1126 White Oak E
Jackson, MI 49201-9547
Phone (517) 769-4296
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4704306197 | Other | MI | RN LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704306197 | MI | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545264000000",
"number": "1144792771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1126 WHITE OAK E",
"city": "JACKSON",
"state": "MI",
"postal_code": "492019547",
"telephone_number": "517-769-4296"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 N WEST AVE",
"city": "JACKSON",
"state": "MI",
"postal_code": "492022179",
"telephone_number": "517-796-4540",
"fax_number": "517-796-4517"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NADEAU",
"first_name": "ANGEL",
"middle_name": "FAY",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-20",
"last_updated": "2018-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MI",
"license": "4704306197",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN LICENSE",
"identifier": "4704306197",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.