Healthcare Provider Details

I. General information

NPI: 1811269038
Provider Name (Legal Business Name): BETTY ANGERVILLE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2012
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 N SAINT PAUL ST STE 3100
DALLAS TX
75201-3923
US

IV. Provider business mailing address

325 N SAINT PAUL ST STE 3100
DALLAS TX
75201-3923
US

V. Phone/Fax

Practice location:
  • Phone: 585-861-6398
  • Fax:
Mailing address:
  • Phone: 585-861-6398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9298938
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: