Individual
MRS. ANGELA KIM SO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
502 S OLD ORCHARD LN STE 126, LEWISVILLE, TX 75067-4374
(972) 436-7962
Mailing address
502 S OLD ORCHARD LN STE 126, LEWISVILLE, TX 75067-4374
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2267193
NY
163W00000X
Registered Nurse
95062551
CA
363LP0200X
Pediatric Nurse Practitioner
Primary
1116695
TX
363LP0200X
Pediatric Nurse Practitioner
95002627
CA
Other
Enumeration date
07/07/2014
Last updated
12/27/2024
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