Basic Information
| Provider Information | |||||||||
| NPI: | 1780871657 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | CHRISTIAN | ||||||||
| FirstName: | ANGELA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 311 N FULTON AVE | ||||||||
| Address2: | APT. 2 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212231602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4104872071 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3300 N RIDGE RD | ||||||||
| Address2: | SUITE 175 | ||||||||
| City: | ELLICOTT CITY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210433383 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107503474 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2007 | ||||||||
| LastUpdateDate: | 09/25/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 376K00000X | A00018160 | MD | Y | Nursing Service Related Providers | Nurse's Aide |
No ID Information.