Angelique Renee Swank, LPN

Individual provider Active NPI Licensed Practical Nurse · Jamestown, OH

NPI 1114342185 · NPPES record last updated Feb 26, 2014

Key facts

NPI
1114342185
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
144788 (OH)
Practice address
4646 Cottonville Rd
Jamestown, OH 45335-1516
Phone
(937) 768-3656
NPI assigned
Feb 26, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
144788OHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 144788 OH Yes

Addresses

Primary practice location

4646 Cottonville Rd
Jamestown, OH 45335-1516

Mailing address

4646 Cottonville Rd
Jamestown, OH 45335-1516
Phone (937) 768-3656

Other names

  • Ms. Angelique Renee Theile Former name

Other providers in Jamestown, OH

All providers in Jamestown, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.