Vanderberg, Angela M

Vanderberg, Angela M is an individual health care provider with primary practice located at 215 W 4Th St , Mishawaka IN 46544-1917. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Vanderberg, Angela M can be contacted via phone (574) 325-5961.

Contact Information

Primary practice address
215 W 4Th St Mishawaka IN 46544-1917
Phone: (574) 325-5961
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71003513 Indiana
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 71003513 Indiana

Profile Details

NPI number 1093019994
LBN Legal business name Vanderberg, Angela M
Credentials Advanced Practice Nurse (APN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 6th, 2011
Last updated Jun 5th, 2024 - about 2 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 1093019994 NPPES
Indiana Other IN2007010 MEDICARE PTAN

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