Basic Information
| Provider Information | |||||||||
| NPI: | 1861819328 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCFARLAND | ||||||||
| FirstName: | ANGELA | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 636988 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452636988 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8889402722 | ||||||||
| FaxNumber: | 5136328898 | ||||||||
| Practice Location | |||||||||
| Address1: | 715 E WESTERN RESERVE RD | ||||||||
| Address2: | |||||||||
| City: | POLAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 445143358 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3307263204 | ||||||||
| FaxNumber: | 3307299316 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2014 | ||||||||
| LastUpdateDate: | 10/08/2015 | ||||||||
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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 | 363LA2200X | SP013717 | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 363LA2200X | COA15174NP | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
ID Information
| ID | Type | State | Issuer | Description | 0120988 | 05 | OH | MEDICAID |