Healthcare Provider Details

I. General information

NPI: 1366856783
Provider Name (Legal Business Name): ANGELA FREED AGPCNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANGELA LOWRY AGPCNP

II. Dates (important events)

Enumeration Date: 06/13/2014
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 STATE RD
ANDERSON OH
45255-2439
US

IV. Provider business mailing address

7500 STATE RD
ANDERSON OH
45255-2439
US

V. Phone/Fax

Practice location:
  • Phone: 513-233-6480
  • Fax: 513-233-6481
Mailing address:
  • Phone: 513-233-6480
  • Fax: 513-233-6481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberCOA.15952-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: