Individual
ANGELLA TAMANDA TAKOMANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
1908 PARK PLACE BLVD APT 816, BEDFORD, TX 76021-7501
(972) 551-9807
Mailing address
1908 PARK PLACE BLVD APT 816, BEDFORD, TX 76021-7501
(972) 551-9807
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
309173
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
309173
—
TX
Enumeration date
02/21/2018
Last updated
02/21/2018
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