Individual
ANGELA MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
655 E MAIN ST, PERU, IN 46970-2662
(765) 472-1931
(765) 472-1945
Mailing address
655 E MAIN ST, PERU, IN 46970-2662
(765) 472-1931
(765) 472-1945
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
27062645A
IN
Other
Enumeration date
05/15/2009
Last updated
05/15/2009
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