MEDICARE: ANGELA TRIPLETT

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	164W00000X	Licensed Practical Nurse	164521	OH

General Provider Information

NPI Number	:	1093233819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA TRIPLETT

Provider Business Mailing Address
First Line	:	1487 E 250TH ST
Second Line	:
City	:	EUCLID
State	:	OH
Zip	:	44117-1204
Country	:	US
Telephone Number	:	216-313-4854
Fax Number	:

Provider Business Practice Location Address
First Line	:	1487 E 250TH ST
Second Line	:
City	:	EUCLID
State	:	OH
Zip	:	44117-1204
Country	:	US
Telephone Number	:	216-313-4854
Fax Number	:

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

Provider Enumeration Date	:	08/31/2017
Last Update Date	:	07/21/2022

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Directions to “ ANGELA TRIPLETT ” Practice Location

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