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General NPI Number Information
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NPI Number | 1730706078
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Entity Type | Organization
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Legal Business Name | MOBILE PRACTITIONER SERVICES INC.
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Dates
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Enumeration Date | 07/02/2020
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Last Update Date | 07/02/2020
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Provider Practice Location Address
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Address Line | 1565 W 36TH ST
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City | RIVIERA BEACH
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State | FL
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Zip | 33404-2009
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Country | US
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Telephone | 561-662-2198
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Fax | 561-828-9884
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Provider Business Mailing Address
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Address Line | 1565 W 36TH ST
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City | RIVIERA BEACH
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State | FL
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Zip | 33404-2009
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Country | US
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Telephone | 561-662-2198
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Fax | 561-828-3884
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Authorized Official
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Title or Position | PMHNP/FNP
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Name | MRS. ANGELA DENISE ENGRAM
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Credential | APRN
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Telephone | 561-662-2198
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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