Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 7860-33 | WI |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 7860-33 | WI |
NPI | 1316462781 |
---|---|
Provider Name | Mrs. Angela Loran Maginn |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53792-4874 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2017 |
Last Update Date | 24/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1316462781 | (05) | WI |