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:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1972929701 | NPPES |
Texas | MEDICAID | 360901801 |
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