Individual
ANGEL WASSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
4647 MANATEE AVE W, BRADENTON, FL 34209-3816
(941) 745-5999
(941) 745-3555
Mailing address
367 S. GULPH RD, ATTN: IPM CREDENTIALING, KING OF PRUSSIA, PA 19406-3121
(941) 745-5999
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
71007719A
IN
363LF0000X
Family Nurse Practitioner
Primary
9280196
FL
Other
Enumeration date
03/06/2017
Last updated
10/31/2018
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