Provider Demographics
NPI:1558083360
Name:PULLEN, ANGELINA TERESA (AP)
Entity Type:Individual
Prefix:DR
First Name:ANGELINA
Middle Name:TERESA
Last Name:PULLEN
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17101 CENTENNIAL LN
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33948-1775
Mailing Address - Country:US
Mailing Address - Phone:941-276-5606
Mailing Address - Fax:
Practice Address - Street 1:3440 CONWAY BLVD
Practice Address - Street 2:UNIT 1D
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-7050
Practice Address - Country:US
Practice Address - Phone:941-787-4488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP4388171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist