Provider Demographics
NPI:1255782579
Name:ANGUS, AUBREY (LPN)
Entity type:Individual
Prefix:MRS
First Name:AUBREY
Middle Name:
Last Name:ANGUS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 MESSIMER DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-1874
Mailing Address - Country:US
Mailing Address - Phone:740-788-0327
Mailing Address - Fax:740-788-3407
Practice Address - Street 1:4103 BENNINGTON CHAPEL RD
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:OH
Practice Address - Zip Code:43080-9582
Practice Address - Country:US
Practice Address - Phone:740-788-0327
Practice Address - Fax:740-788-3407
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.120332-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse