Organization
ANGEL HEALTHCARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EMMANUEL MUKENDI CRNP (MANAGER)
(717) 333-1919
Entity
Organization
Contact information
Practice address
406 KEINATH ST, MOUNT JOY, PA 17552-3165
(717) 333-1919
Mailing address
406 KEINATH ST, MOUNT JOY, PA 17552-3165
(717) 333-1919
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103263652
—
PA
Enumeration date
06/21/2019
Last updated
06/21/2019
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