Angelo, Jennifer Lee

Angelo, Jennifer Lee is an individual health care provider with primary practice located at 3211 N 4Th St Suite A, Longview TX 75605-5145. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Angelo, Jennifer Lee can be contacted via phone (903) 297-6500.

Contact Information

Primary practice address
3211 N 4Th St Suite A Longview TX 75605-5145
Phone: (903) 297-6500
Fax: (903) 297-6510
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 651630 Texas

Profile Details

NPI number 1851676134
LBN Legal business name Angelo, Jennifer Lee
Credentials RN, PMHNP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2011
Last updated Feb 21st, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851676134 NPPES
Texas MEDICAID 293397001

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