Individual
ANGELA M KLOCK
Active
Individual
ANGELA M KLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN507577L
PA
367A00000X
Advanced Practice Midwife
Primary
MW010391
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100746682 0006
—
PA
05
—
101814491
—
PA
Enumeration date
11/14/2007
Last updated
10/12/2018
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