Northcutt, Angela M

Northcutt, Angela M is an individual health care provider with primary practice located at 123 S Franklin Rd , Bloomington IN 47404-5296. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Northcutt, Angela M can be contacted via phone (812) 778-3116.

Contact Information

Primary practice address
123 S Franklin Rd Bloomington IN 47404-5296
Phone: (812) 778-3116
Fax: (812) 778-3117
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 9948 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 1612-023 West Virginia
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA04880 Texas
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 10003396A Indiana

Profile Details

NPI number 1740287119
LBN Legal business name Northcutt, Angela M
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2005
Last updated Jan 11th, 2023 - about 3 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 1740287119 NPPES
Texas Other 8N9563 BLUE CROSS BLUE SHIELD OF
Texas MEDICAID 42865500 BLUE CROSS BLUE SHIELD OF
Texas MEDICAID 559168600 BLUE CROSS BLUE SHIELD OF

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