MEDICARE: ANGELA CHRISTINA ATKINS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174H00000X	Health Educator

General Provider Information

NPI Number	:	1063934297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA CHRISTINA ATKINS

Provider Business Mailing Address
First Line	:	5333 MONTGOMERY RD
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-7017
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5333 MONTGOMERY RD
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-7017
Country	:	US
Telephone Number	:	909-312-6224
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2017
Last Update Date	:	07/10/2017

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