Provider Demographics
NPI:1639500218
Name:DENTON, ANGELLA MARLENE (RN)
Entity Type:Individual
Prefix:
First Name:ANGELLA
Middle Name:MARLENE
Last Name:DENTON
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 1:13119 226TH ST
Mailing Address - Street 2:
Mailing Address - City:LAURELTON
Mailing Address - State:NY
Mailing Address - Zip Code:11413-1733
Mailing Address - Country:US
Mailing Address - Phone:718-341-1840
Mailing Address - Fax:
Practice Address - Street 1:13119 226TH ST
Practice Address - Street 2:
Practice Address - City:LAURELTON
Practice Address - State:NY
Practice Address - Zip Code:11413-1733
Practice Address - Country:US
Practice Address - Phone:718-341-1840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-06
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY521198163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse