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Individual
MRS. ANGELA C ANDERSON
Active
Individual
MRS. ANGELA C ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN, NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN1003560
DC
363LA2200X
Adult Health Nurse Practitioner
Primary
RN1003560
DC
363LP2300X
Primary Care Nurse Practitioner
RN1003560
DC
Other
Enumeration date
03/09/2021
Last updated
03/09/2021
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