| NPI | 1639128739 | 
|---|---|
| Former Name | VIRGINIA JEAN ANGERT | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R122264)  | 
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IN 71003108A)  | 
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 381890)  | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: IN 71003108B)  | |
| Enumeration Date | 2006-05-08 | 
| Last Update Date | 2021-09-01 |