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Individual

MRS. ANGELA NICOLE THORN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP-PN

Contact information

Practice address
609 W COURT ST STE B, WINNFIELD, LA 71483-2686
(318) 209-4646
(318) 209-4649
Mailing address
609 W COURT ST, WINNFIELD, LA 71483-2681
(318) 623-2716

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP05870
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
18001139
LA
05
1800139
LA
Enumeration date
09/16/2009
Last updated
04/26/2021
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