Provider Demographics
NPI:1679258172
Name:BUCHANAN, ANGELA TERESA (LPN)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:TERESA
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 GOOD HOPE RD SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-6912
Mailing Address - Country:US
Mailing Address - Phone:202-610-1886
Mailing Address - Fax:
Practice Address - Street 1:1320 GOOD HOPE RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-6912
Practice Address - Country:US
Practice Address - Phone:202-610-1886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1003514164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse