Lisa Angle

Individual provider Active NPI School Registered Nurse · Rome, NY

NPI 1326440975 · NPPES record last updated Sep 25, 2014

Key facts

NPI
1326440975
Entity type
Individual (NPI type 1)
Primary specialty
School Registered Nurse 163WS0200X
License
691465 (NY)
Practice address
8194 Bielby Rd
Rome, NY 13440-1915
Phone
(315) 334-1260
NPI assigned
Sep 25, 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
691465NYMDSchool Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 691465 NY Yes

Addresses

Primary practice location

8194 Bielby Rd
Rome, NY 13440-1915

Mailing address

123 Cooper Street
Oriskany Falls, NY 13425

Other providers in Rome, NY

All providers in Rome, NY · School Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.