Provider Demographics
NPI:1821721838
Name:BUCCI, ANGELA ROSALIE (FNP-BC)
Entity Type:Individual
Prefix:MISS
First Name:ANGELA
Middle Name:ROSALIE
Last Name:BUCCI
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38056 OPATIK CT
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-1408
Mailing Address - Country:US
Mailing Address - Phone:586-770-8194
Mailing Address - Fax:
Practice Address - Street 1:38056 OPATIK CT
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48312-1408
Practice Address - Country:US
Practice Address - Phone:586-770-8194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704349132363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily