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General NPI Number Information
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NPI Number | 1700187754
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Entity Type | Individual
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Provider Name | ANGIE KAY JARRELL L.P.N
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Gender | Female
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Dates
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Enumeration Date | 11/08/2010
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Last Update Date | 11/08/2010
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Provider Practice Location Address
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Address Line | 198 NC HIGHWAY 45 N
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City | PLYMOUTH
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State | NC
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Zip | 27962-9232
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Country | US
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Telephone | 252-791-3155
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Fax |
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Provider Business Mailing Address
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Address Line | 511 SEAVIEW DR
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City | EDENTON
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State | NC
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Zip | 27932-9269
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Country | US
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Telephone | 252-337-4882
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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 | 69065
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License Number State | NC
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