Provider Demographics
NPI:1932288834
Name:MOCK, ANGELA SINOPOLI (CRN7A)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:SINOPOLI
Last Name:MOCK
Suffix:
Gender:F
Credentials:CRN7A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13647
Mailing Address - Street 2:5311 PAULSEN STREET
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31416
Mailing Address - Country:US
Mailing Address - Phone:912-355-7766
Mailing Address - Fax:912-692-0985
Practice Address - Street 1:5311 PAULSEN STREET
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31416
Practice Address - Country:US
Practice Address - Phone:912-355-7766
Practice Address - Fax:912-692-0985
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN066820163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
021806OtherCERTIFICATION BOARD PERIO
GARN066820OtherLICENSE NUMBER