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NPI Code Detail

MEDICARE: ANGELA FARRISON BOFFAH

MEDICARE: ANGELA FARRISON BOFFAH
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
1163WC1500XCommunity Health Registered Nurse147857TN

General Provider Information

NPI Number : 1689911109
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA FARRISON BOFFAH
Provider Business Mailing Address
First Line : 311 23RD AVE N
Second Line :
City : NASHVILLE
State : TN
Zip : 37203-1503
Country : US
Telephone Number : 615-340-5616
Fax Number :
Provider Business Practice Location Address
First Line : 1015 E TRINITY LN
Second Line :
City : NASHVILLE
State : TN
Zip : 37216-3029
Country : US
Telephone Number : 615-880-2159
Fax Number : 615-880-2203
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2013
Last Update Date : 01/04/2013

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Directions to “ ANGELA FARRISON BOFFAH ” Practice Location

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