Provider Demographics
NPI:1184975294
Name:OBEY, ANGIE MARIE (REGISTERED NURSE)
Entity type:Individual
Prefix:MS
First Name:ANGIE
Middle Name:MARIE
Last Name:OBEY
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 BALL ROAD
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NY
Mailing Address - Zip Code:13076-3148
Mailing Address - Country:US
Mailing Address - Phone:315-708-3356
Mailing Address - Fax:
Practice Address - Street 1:12 BALL ROAD
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NY
Practice Address - Zip Code:13076-3148
Practice Address - Country:US
Practice Address - Phone:315-708-3356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY559816163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse