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ANGELA SUELINE CARROLL R.N.

Nursing & Custodial Care Facilities Nursing Facility/Intermediate Care Facility

Provider NPI: 1194017194

Provider Information:
 ANGELA SUELINE CARROLL R.N.
Gender: F
Sole Proprietor

Practice Location:
6228 W KAUL AVE APT 1  MILWAUKEE, WI 53218-1527 US
Tel: 262-344-4002  Fax: --

Business Mailing Address:
6228 W KAUL AVE APT 1  MILWAUKEE, WI 53218-1527 US
Tel: 262-344-4002  Fax: --

NPI Information:
NPI: 1194017194
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y313M00000XNursing & Custodial Care Facilities
Nursing Facility/Intermediate Care Facility
WI155143-030
N3104A0625XNursing & Custodial Care Facilities
Assisted Living Facility
WI155143-030

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 313M00000X

Type:

Classification:



Definition:



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