Provider Demographics
NPI:1003115718
Name:ARSENAULT, ANGELA J H (FNP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:J H
Last Name:ARSENAULT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1669 HAMILTON RD STE 220
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-1960
Mailing Address - Country:US
Mailing Address - Phone:517-993-6366
Mailing Address - Fax:517-483-2350
Practice Address - Street 1:1669 HAMILTON RD STE 220
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-1960
Practice Address - Country:US
Practice Address - Phone:517-993-6366
Practice Address - Fax:517-483-2350
Is Sole Proprietor?:No
Enumeration Date:2011-03-21
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704283310363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily