Provider Demographics
NPI:1922504620
Name:MICHAEL, ANGELINE JULIANA (NP)
Entity Type:Individual
Prefix:MRS
First Name:ANGELINE
Middle Name:JULIANA
Last Name:MICHAEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8304 SANDHILL CRANE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76118-4500
Mailing Address - Country:US
Mailing Address - Phone:732-614-6788
Mailing Address - Fax:
Practice Address - Street 1:111 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75207-7401
Practice Address - Country:US
Practice Address - Phone:214-875-2010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX801101363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health