Individual
ANGELA ROSE BRACEWELL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
12832 NW CENTRAL AVE, BRISTOL, FL 32321
(850) 643-2415
(850) 643-5689
Mailing address
17502 NE PEAR ST, BLOUNTSTOWN, FL 32424-1421
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN9219673
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN9219673
NURSING LICENSE
FL
Enumeration date
01/24/2006
Last updated
07/08/2007
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