Cynthia Angell

Individual provider Active NPI Skilled Nursing Facility · Roscommon, MI

NPI 1215368337 · NPPES record last updated Dec 1, 2013

Key facts

NPI
1215368337
Entity type
Individual (NPI type 1)
Primary specialty
Skilled Nursing Facility 314000000X
License
5201003740 (MI)
Practice address
1290 E Michigan Hwy
Roscommon, MI 48653-8757
Phone
(989) 275-8936
Fax
(989) 275-4808
NPI assigned
Dec 1, 2013
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
5201003740MIMDSkilled Nursing Facility

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 5201003740 MI Yes

Addresses

Primary practice location

1290 E Michigan Hwy
Roscommon, MI 48653-8757

Mailing address

1290 E Michigan Hwy
Roscommon, MI 48653-8757
Phone (989) 275-8936

Other identifiers

IdentifierTypeStateIssuer
5201003740OtherMIOT LICENCE 5201003740

Other providers in Roscommon, MI

All providers in Roscommon, MI · Skilled Nursing Facility in Michigan

Sources for this page

Verify at the official NPI Registry.