Provider Demographics
NPI:1932411741
Name:KRUSE-FARAMARZI, ANGELA (RN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:KRUSE-FARAMARZI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:FARAMARZI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:201 S BARNES DR
Mailing Address - Street 2:#1117
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-7219
Mailing Address - Country:US
Mailing Address - Phone:972-487-8793
Mailing Address - Fax:972-487-8513
Practice Address - Street 1:201 S BARNES DR
Practice Address - Street 2:#1117
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-7219
Practice Address - Country:US
Practice Address - Phone:972-487-8793
Practice Address - Fax:972-487-8513
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-09
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX583203163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health