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Individual
MRS. ANGELA LYNN PUCKETT
Active
Individual
MRS. ANGELA LYNN PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3008947
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201322020
—
IN
05
—
7100316590
—
KY
Enumeration date
09/17/2014
Last updated
09/14/2020
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