Individual
ANGELIA M MICKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4940 COTTONVILLE RD, STE 100, JAMESTOWN, OH 45335
(937) 675-6830
(937) 675-6835
Mailing address
4940 COTTONVILLE RD STE 100, JAMESTOWN, OH 45335-1522
(937) 675-2870
(937) 675-2873
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
COA.14976-NP
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
APRN.CNP.14976
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0095517
—
OH
Enumeration date
08/07/2013
Last updated
03/25/2025
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