Individual
MRS. ANGELA MISSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
602 SW 38TH ST, LAWTON, OK 73505-6912
(580) 248-5780
(580) 248-3610
Mailing address
7124 NW BIRCH PL, LAWTON, OK 73505-4241
(940) 224-7236
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
202469
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13647891
DL
TX
Enumeration date
11/01/2022
Last updated
11/01/2022
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