Individual
ANGELA LYNNE FEDERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5109 WORLD DAIRY DR, MADISON, WI 53718-3807
(608) 709-4423
Mailing address
6930 MILL BLUFF DR, MADISON, WI 53718-3214
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
29225-031
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164W00000X
—
WI
Enumeration date
08/07/2018
Last updated
08/07/2018
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