Individual
ANGELA VOGT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
601 W 2ND ST, BLOOMINGTON, IN 47403-2317
(812) 353-9515
(812) 353-9275
Mailing address
601 W 2ND ST, BLOOMINGTON, IN 47403-2317
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
71004082A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
71004082A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201100950
—
IN
Enumeration date
08/14/2012
Last updated
07/19/2022
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