Ethridge, Angela D

Ethridge, Angela D is an individual health care provider with primary practice located at 561 Ethridge Ln , Coxs Creek KY 40013-8857. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Ethridge, Angela D can be contacted via phone (502) 262-7929.

Contact Information

Primary practice address
561 Ethridge Ln Coxs Creek KY 40013-8857
Phone: (502) 262-7929
Fax: (833) 449-5151
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 3006302 Kentucky

Profile Details

NPI number 1619206885
LBN Legal business name Ethridge, Angela D
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 16th, 2009
Last updated May 8th, 2024 - about 6 months 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 1619206885 NPPES
Kentucky Other 000000746393 ANTHEM
Kentucky MEDICAID 7100109880 ANTHEM
Kentucky Other 50036061 ANTHEM

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