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Individual

ANGELA MARIE PRICKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.-C

Contact information

Practice address
3700 SOUTHERN BLVD STE 300, KETTERING, OH 45429-1265
(937) 643-9299
(937) 643-2343
Mailing address
1 PRESTIGE PL STE 550, MIAMISBURG, OH 45342-6115
(937) 762-1310
(937) 522-8068

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN.CNP.10951
OH
363LF0000X
Family Nurse Practitioner
COA.10951-NP
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0081729
OH
Enumeration date
09/16/2009
Last updated
07/09/2021
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