Individual
ANGELLA D BASCOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.R.N.P.
Contact information
Practice address
9283 SAN JOSE BLVD # B-2S1, JACKSONVILLE, FL 32257-5584
(904) 268-5826
(904) 268-5826
Mailing address
9283 SAN JOSE BLVD # B-2S1, JACKSONVILLE, FL 32257-5584
(904) 268-5826
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
ARNP9238929
FL
363LF0000X
Family Nurse Practitioner
RN2269970
MA
Other
Enumeration date
11/17/2006
Last updated
07/21/2022
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