Basic Information
| Provider Information | |||||||||
| NPI: | 1609022631 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROBERTS | ||||||||
| FirstName: | ANGELA | ||||||||
| MiddleName: | THIGPEN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | |||||||||
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| Mailing Information | |||||||||
| Address1: | UNIT 6 MEADOW LANE | ||||||||
| Address2: | |||||||||
| City: | PINEVILLE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 713600118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3184846400 | ||||||||
| FaxNumber: | 3184875703 | ||||||||
| Practice Location | |||||||||
| Address1: | UNIT 6 MEADOW LANE | ||||||||
| Address2: | |||||||||
| City: | PINEVILLE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 713600118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3184846400 | ||||||||
| FaxNumber: | 3184875703 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2008 | ||||||||
| LastUpdateDate: | 08/11/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164W00000X | 280741 | LA | Y | Nursing Service Providers | Licensed Practical Nurse |
No ID Information.