Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 0001154919 | VA |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 0024170012 | VA |
NPI | 1093072225 |
---|---|
Provider Name | Mrs. Angela Lynn Titus |
First Address | Winchester, VA 22601-2892 |
Second Address | Winchester, VA 22601-2892 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2012 |
Last Update Date | 30/01/2018 |