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NPI Code Detail

MEDICARE: MRS. ANGELA RENEE' PAUGH APRN-CNP

MEDICARE: MRS. ANGELA RENEE' PAUGH APRN-CNP
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
1363LP2300XPrimary Care Nurse PractitionerAPRN.CNP023753OH

General Provider Information

NPI Number : 1518524065
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANGELA RENEE' PAUGH APRN-CNP
Provider Business Mailing Address
First Line : 1 PRESTIGE PL STE 550
Second Line :
City : MIAMISBURG
State : OH
Zip : 45342-6115
Country : US
Telephone Number : 937-762-1310
Fax Number : 937-522-8068
Provider Business Practice Location Address
First Line : 4790 COTTONVILLE RD
Second Line :
City : JAMESTOWN
State : OH
Zip : 45335-1518
Country : US
Telephone Number : 937-675-2870
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2019
Last Update Date : 05/24/2021

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