Individual
MRS. ANGELA RAE ROUGHLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
1201 VALLEY VW, CHOCTAW, OK 73020-6823
(405) 454-2454
Mailing address
1201 VALLEY VW, CHOCTAW, OK 73020-6823
(405) 454-2454
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0072047
OK
Other
Enumeration date
10/05/2010
Last updated
10/05/2010
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