Organization
ANGELA STATHOPOULOS
Active
Other names
Angela Stathopoulos
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA MARIA CAMPOS (OFFICE MANAGER)
(517) 347-4848
Entity
Organization
Contact information
Practice address
4084 OKEMOS RD STE A, OKEMOS, MI 48864-3258
(517) 347-4848
(517) 347-4844
Mailing address
4084 OKEMOS RD STE A, OKEMOS, MI 48864-3258
(517) 347-4848
(517) 347-4844
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704235236
STATE OF MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS
MI
Enumeration date
05/04/2022
Last updated
05/04/2022
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