Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 4704283310 | MI |
NPI | 1003115718 |
---|---|
Provider Name | Angela J H Arsenault |
First Address | East Lansing, MI 48824-7500 |
Second Address | East Lansing, MI 48824-7500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2011 |
Last Update Date | 19/03/2018 |