| NPI | 1447826672 |
|---|---|
| Former Name | ANGELA MARY BACON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL APRN11010798) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11010798) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: FL APRN11010798) | |
| Enumeration Date | 2021-05-28 |
| Last Update Date | 2025-09-17 |