Individual
ANGELA JOY FENNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LM, CPM
Contact information
Practice address
27619 25TH PL, BRANFORD, FL 32008-2107
(386) 288-0698
(800) 853-5087
Mailing address
1468 SW MAIN BLVD STE 105-94, LAKE CITY, FL 32025-1115
(386) 288-0698
(800) 853-5087
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
MW294
FL
Other
Enumeration date
08/27/2014
Last updated
02/10/2023
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