Provider Demographics
NPI:1134989270
Name:COLLIGAN, ANGELA CRISTINA
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:CRISTINA
Last Name:COLLIGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-3467
Mailing Address - Country:US
Mailing Address - Phone:517-962-8529
Mailing Address - Fax:517-962-8529
Practice Address - Street 1:728 N STATE ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-3467
Practice Address - Country:US
Practice Address - Phone:517-962-8529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No172A00000XOther Service ProvidersDriver
No372500000XNursing Service Related ProvidersChore Provider