Individual
ANGIE PUTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
142 NORMAN ST, LUFKIN, TX 75904-4746
(936) 671-3203
Mailing address
142 NORMAN ST, LUFKIN, TX 75904-4746
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
191494
TX
164X00000X
Licensed Vocational Nurse
Primary
191494
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164X00000X
—
TX
05
—
191494
—
TX
Enumeration date
02/19/2018
Last updated
02/19/2018
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