Provider Demographics
NPI:1710179601
Name:MUSSER, ANGELA C (ADULT COMPANION)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:C
Last Name:MUSSER
Suffix:
Gender:F
Credentials:ADULT COMPANION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8471 STATE ROUTE 247
Mailing Address - Street 2:
Mailing Address - City:WEST UNION
Mailing Address - State:OH
Mailing Address - Zip Code:45693-9711
Mailing Address - Country:US
Mailing Address - Phone:937-779-9527
Mailing Address - Fax:
Practice Address - Street 1:8471 STATE ROUTE 247
Practice Address - Street 2:
Practice Address - City:WEST UNION
Practice Address - State:OH
Practice Address - Zip Code:45693-9711
Practice Address - Country:US
Practice Address - Phone:937-779-9527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRH601940372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2738407Medicaid