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General NPI Number Information
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NPI Number | 1265857577
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Entity Type | Individual
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Provider Name | AMANDA DANIELLE ANGUS CRNA
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Gender | Female
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Dates
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Enumeration Date | 02/24/2014
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 150 7TH AVE
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City | CHARDON
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State | OH
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Zip | 44024-2908
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Country | US
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Telephone | 440-285-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 356 MINER RD
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City | HIGHLAND HTS
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State | OH
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Zip | 44143-1537
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Country | US
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Telephone | 855-205-0220
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.0040762
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | COA15713-NA
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License Number State | OH
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