Individual
NICHOLAS MICHAEL ANGELIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4901 GRANDE DR, PENSACOLA, FL 32504-5935
(850) 477-7042
(850) 474-9060
Mailing address
4901 GRANDE DR, PENSACOLA, FL 32504-5935
(850) 477-7042
(850) 474-9060
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9271609
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002764500
—
FL
05
—
122741
—
AL
01
—
592-12787
BLUE CROSS BLUE SHIELD
AL
01
—
G00JE
BLUE CROSS BLUE SHIELD
FL
Enumeration date
09/20/2010
Last updated
11/04/2011
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