Healthcare Provider Details
I. General information
NPI: 1750318317
Provider Name (Legal Business Name): ANGELINE M CURTIS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1670 CLAIRMONT RD 116B
DECATUR GA
30033-4004
US
IV. Provider business mailing address
1670 CLAIRMONT RD, 116B
DECATUR GA
30033
US
V. Phone/Fax
- Phone: 404-321-6111
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 364SP0809X |
| Taxonomy | Adult Psychiatric/Mental Health Clinical Nurse Specialist |
| License Number | RN042883 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: