Provider Demographics
NPI:1669781928
Name:WARD, ANGELA O (RN)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:O
Last Name:WARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2129 BRIARCLIFF CIR
Mailing Address - Street 2:
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757-6965
Mailing Address - Country:US
Mailing Address - Phone:352-551-4470
Mailing Address - Fax:
Practice Address - Street 1:2129 BRIARCLIFF CIR
Practice Address - Street 2:
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-6965
Practice Address - Country:US
Practice Address - Phone:352-551-4470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9233898163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse