| NPI | 1114271517 |
|---|---|
| Former Name | ANGELA LOGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CT 005164) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 005164) |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2015-07-01 |