Individual
ANGELIQUE JOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
830 EZZARD CHARLES DR, CINCINNATI, OH 45214-2525
(513) 381-6672
Mailing address
446 MORGAN ST, CINCINNATI, OH 45206-2348
(513) 834-7063
(513) 873-1567
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN.156147.MEDS-IV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PN156147-IV
LPN
OH
Enumeration date
04/06/2017
Last updated
10/26/2022
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