MEDICARE: MS. DIANA J ANGUS CNP, MS, BC

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	363LA2200X	Adult Health Nurse Practitioner	NP-3326	OH

General Provider Information

NPI Number	:	1932282910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DIANA J ANGUS CNP, MS, BC

Provider Business Mailing Address
First Line	:	871 TROON TRL
Second Line	:
City	:	WORTHINGTON
State	:	OH
Zip	:	43085-2929
Country	:	US
Telephone Number	:	614-847-5857
Fax Number	:

Provider Business Practice Location Address
First Line	:	849 HARMON AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43223-2411
Country	:	US
Telephone Number	:	614-221-6870
Fax Number	:	614-221-6890

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

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	05/31/2008

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