Provider Demographics
NPI:1912203423
Name:BORJON, ANGELA SUE (RN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:SUE
Last Name:BORJON
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 1:814 CRAIG AVE SW # 2
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:MN
Mailing Address - Zip Code:55350-3010
Mailing Address - Country:US
Mailing Address - Phone:320-296-2227
Mailing Address - Fax:320-234-7950
Practice Address - Street 1:814 CRAIG AVE SW # 2
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-3010
Practice Address - Country:US
Practice Address - Phone:320-296-2227
Practice Address - Fax:320-234-7950
Is Sole Proprietor?:No
Enumeration Date:2011-01-31
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR188236-6163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse