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General NPI Number Information
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NPI Number | 1366135931
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Entity Type | Individual
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Provider Name | HERMENIGILDA ANG EUSEBIO FNP
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Gender | Female
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Dates
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Enumeration Date | 05/31/2023
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 2930 S MERIDIAN STE 200
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City | PUYALLUP
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State | WA
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Zip | 98373-1654
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Country | US
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Telephone | 253-445-7600
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Fax | 253-864-5999
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Provider Business Mailing Address
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Address Line | 2930 S MERIDIAN STE 200
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City | PUYALLUP
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State | WA
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Zip | 98373-1654
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Country | US
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Telephone | 253-445-7600
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Fax | 253-864-5999
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024187189
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP61592114
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License Number State | WA
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