Provider Demographics
NPI:1154830263
Name:KRUTSICK, ANGELA NICOLE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:NICOLE
Last Name:KRUTSICK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4335 LENMAR DR
Mailing Address - Street 2:
Mailing Address - City:COPLAY
Mailing Address - State:PA
Mailing Address - Zip Code:18037-2257
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2240 SCHOENERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-3601
Practice Address - Country:US
Practice Address - Phone:610-861-7494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-21
Last Update Date:2017-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP451759183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist