Healthcare Provider Details

I. General information

NPI: 1316870280
Provider Name (Legal Business Name): ANGELA L TUSSEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MADISON ST
MOUNT STERLING OH
43143-1021
US

IV. Provider business mailing address

230 S OAK ST
LONDON OH
43140-1517
US

V. Phone/Fax

Practice location:
  • Phone: 614-633-9827
  • Fax:
Mailing address:
  • Phone: 614-633-9827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: