Individual
ANGELA THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
18250 MIDDLEBELT RD, APT 201, LIVONIA, MI 48152-5004
(313) 208-2989
Mailing address
18250 MIDDLEBELT RD, APT 201, LIVONIA, MI 48152-5004
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703090943
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4703090943
LPN LICENSE
MI
Enumeration date
08/28/2013
Last updated
08/28/2013
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