Provider Demographics
NPI:1023587060
Name:ESSER, ANGELA E
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:E
Last Name:ESSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANGIE
Other - Middle Name:E
Other - Last Name:ESSER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1034 MERKLIN DR
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MO
Mailing Address - Zip Code:65251-2921
Mailing Address - Country:US
Mailing Address - Phone:573-355-5939
Mailing Address - Fax:
Practice Address - Street 1:3165 MCKELVEY RD STE 200
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-2550
Practice Address - Country:US
Practice Address - Phone:314-206-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-20
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program