Clark, Angela

Clark, Angela is an individual health care provider with primary practice located at 3555 Knickerbocker Rd , San Angelo TX 76904-7610. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Clark, Angela can be contacted via phone (325) 949-9555.

Contact Information

Primary practice address
3555 Knickerbocker Rd San Angelo TX 76904-7610
Phone: (325) 949-9555
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X AP130678 Texas

Profile Details

NPI number 1972929701
LBN Legal business name Clark, Angela
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 18th, 2014
Last updated Dec 8th, 2021 - about 3 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 1972929701 NPPES
Texas MEDICAID 360901801

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