Healthcare Provider Details

I. General information

NPI: 1649521055
Provider Name (Legal Business Name): ANGELA DEE BARMES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2012
Last Update Date: 09/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 OLD BRUCEVILLE RD
VINCENNES IN
47591-3889
US

IV. Provider business mailing address

3204 E STATE ROAD 61
VINCENNES IN
47591-9060
US

V. Phone/Fax

Practice location:
  • Phone: 812-886-4677
  • Fax: 812-886-4678
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number06000279A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: