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Individual

ANGELA R IRVIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
215 CENTRAL AVE, SUITE 102, LOUISVILLE, KY 40208-1418
(502) 852-7449
(502) 852-1423
Mailing address
501 E BROADWAY, SUITE 290, LOUISVILLE, KY 40202-1785
(502) 217-8221
(502) 217-5056

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4734P
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200861110
IN
05
78018280
KY
Enumeration date
02/14/2007
Last updated
01/12/2010
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