Provider Demographics
NPI:1194036343
Name:JARRETT, ANGELA ELAINE (RN)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:ELAINE
Last Name:JARRETT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 MACGHEE RD
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-4360
Mailing Address - Country:US
Mailing Address - Phone:845-240-1109
Mailing Address - Fax:
Practice Address - Street 1:111 MACGHEE RD
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-4360
Practice Address - Country:US
Practice Address - Phone:845-240-1109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY620121163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse