Healthcare Provider Details

I. General information

NPI: 1538082763
Provider Name (Legal Business Name): MS. ANGILINE B MULBAH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1480 16TH ST E UNIT 113
WEST FARGO ND
58078-3433
US

IV. Provider business mailing address

1480 16TH ST E UNIT 113
WEST FARGO ND
58078-3433
US

V. Phone/Fax

Practice location:
  • Phone: 609-510-7149
  • Fax:
Mailing address:
  • Phone: 609-510-7149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: