MEDICARE: ANGELA M OLDANI RN FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	2019017411	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2019017411	OTHER	MO	LICENSURE

General Provider Information

NPI Number	:	1194383596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA M OLDANI RN FNP-C

Provider Business Mailing Address
First Line	:	PO BOX 955534
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63195-5534
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1035 BELLEVUE AVE STE 400
Second Line	:
City	:	RICHMOND HEIGHTS
State	:	MO
Zip	:	63117-1844
Country	:	US
Telephone Number	:	314-925-4700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2019
Last Update Date	:	10/26/2020

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