Provider Demographics
NPI:1164419099
Name:STIKELEATHER, ANGELINE CLAIRE (CNM)
Entity Type:Individual
Prefix:MS
First Name:ANGELINE
Middle Name:CLAIRE
Last Name:STIKELEATHER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:839 FOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-4532
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:694 GOOD DR
Practice Address - Street 2:MAY-GRANT ASSOCIATES
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2433
Practice Address - Country:US
Practice Address - Phone:717-397-8177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMW008371L163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01880055Medicaid