Individual
ANGELA LYNN MIRACLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
54818 US HIGHWAY 50, LONDONDERRY, OH 45647-8938
(740) 637-0754
Mailing address
54818 US HIGHWAY 50, LONDONDERRY, OH 45647-8938
(740) 637-0754
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN.147291-M-IV
OH
Other
Enumeration date
03/26/2013
Last updated
03/26/2013
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