Provider Demographics
NPI:1669428470
Name:ANGLE, CHARITY LEE (RN CNP)
Entity type:Individual
Prefix:
First Name:CHARITY
Middle Name:LEE
Last Name:ANGLE
Suffix:
Gender:F
Credentials:RN CNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2800 CHICAGO AV S
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1320
Mailing Address - Country:US
Mailing Address - Phone:612-863-5390
Mailing Address - Fax:612-863-2697
Practice Address - Street 1:2800 CHICAGO AV S
Practice Address - Street 2:SUITE 300
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-1320
Practice Address - Country:US
Practice Address - Phone:612-863-5390
Practice Address - Fax:612-863-2697
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNR0939197207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0702579OtherMEDICA
MN1025748OtherPREFERRED ONE
MN1195484OtherAMERICAS PPO
MNHP32734OtherHEALTH PARTNERS
MN64G42ANOtherBLUE CROSS