Individual
ANGELA ROUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
580 STAUNTON COMMONS DR APT E2, TROY, OH 45373-2174
(937) 524-1836
Mailing address
580 STAUNTON COMMONS DR APT E2, TROY, OH 45373-2174
(937) 524-1836
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN171010
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPN171010
LPN CERTIFICATION
OH
Enumeration date
01/17/2021
Last updated
01/17/2021
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