Individual
MS. ANGELA LEE TABAKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
3015 N BALLAS RD, ST LOUIS, SAINT LOUIS, MO 63131-2329
(314) 996-5223
Mailing address
3015 N BALLAS RD, ST LOUIS, SAINT LOUIS, MO 63131-2329
(314) 996-5223
Taxonomy
Speciality
Code
Description
License number
State
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
153779
MO
Other
Enumeration date
07/31/2006
Last updated
07/08/2007
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