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General NPI Number Information
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NPI Number | 1073354254
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Entity Type | Individual
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Provider Name | ROXANNE ANGLIN LPN
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Gender | Female
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 54 KENYON ST
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City | STRATFORD
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State | CT
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Zip | 06614-2510
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Country | US
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Telephone | 347-259-1983
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Fax |
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Provider Business Mailing Address
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Address Line | 154 BRADLEY ST
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City | BRIDGEPORT
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State | CT
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Zip | 06610-2008
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Country | US
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Telephone | 203-543-2812
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 38556
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License Number State | CT
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