Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 33822 | NC |
NPI | 1023275138 |
---|---|
Provider Name | Mrs. Angela T Donnelly |
First Address | East Bend, NC 27018-8782 |
Second Address | East Bend, NC 27018-8782 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2008 |
Last Update Date | 19/05/2008 |