Individual
ANGEL A COLBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
7988 HEADWATER DR, BLACKLICK, OH 43004-8070
(614) 649-3576
Mailing address
7988 HEADWATER DR, BLACKLICK, OH 43004-8070
(614) 649-3576
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN 126439
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0084172
—
OH
Enumeration date
03/22/2013
Last updated
03/17/2018
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