Angle, Beth

Angle, Beth is an individual health care provider with primary practice located at 904 E. Martin Luther King Drive , Centralia IL 62801-3058. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Angle, Beth can be contacted via phone (618) 533-1391.

Contact Information

Primary practice address
904 E. Martin Luther King Drive Centralia IL 62801-3058
Phone: (618) 533-1391
Fax: (618) 533-0012
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 043123661 Illinois

Profile Details

NPI number 1639683824
LBN Legal business name Angle, Beth
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 27th, 2017
Last updated Nov 27th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639683824 NPPES
Illinois MEDICAID 370915481007

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