Individual
MRS. ANGIE LAYNE CICCARELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
42 PEAKS VIEW DR, MONETA, VA 24121-2566
(540) 243-4407
Mailing address
42 PEAKS VIEW DR, MONETA, VA 24121-2566
(540) 243-4407
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001254640
VA
163WC0400X
Case Management Registered Nurse
0001254640
VA
251J00000X
Nursing Care Agency
0001254640
VA
Other
Enumeration date
02/26/2025
Last updated
02/26/2025
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