Provider Demographics
NPI:1982217899
Name:MULCAHY, ANGELA (RN BSN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:MULCAHY
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4675 S ACOMA ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-5739
Mailing Address - Country:US
Mailing Address - Phone:970-219-2212
Mailing Address - Fax:
Practice Address - Street 1:4675 S ACOMA ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110-5739
Practice Address - Country:US
Practice Address - Phone:970-219-2212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.0130654163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health