Provider Demographics
NPI:1922540384
Name:GILMORE, ANGELA LEE (RN)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:LEE
Last Name:GILMORE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:ANGELA
Other - Middle Name:LEE
Other - Last Name:LITTLEWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:288 HOLTSHIRE RD.
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:MA
Mailing Address - Zip Code:01364
Mailing Address - Country:US
Mailing Address - Phone:978-855-7474
Mailing Address - Fax:
Practice Address - Street 1:288 HOLTSHIRE RD.
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:MA
Practice Address - Zip Code:01364
Practice Address - Country:US
Practice Address - Phone:978-855-7474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-15
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2300324163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110120262OtherMASS HEALTH PROVIDER