Lyssa Jeanne Agreste Angis
Nurse Practitioner in Scarborough, ME. Individual provider (NPI-1).
NPI number1235827551
StatusActive
Last updated in NPPESJun 8, 2023
Details
- NPI
- 1235827551
- Entity type
- Individual (NPI-1)
- Name
- Lyssa Jeanne Agreste Angis
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 25, 2023
- Certification date
- Jun 8, 2023
- Last updated
- Jun 8, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | CNP221099 | ME | Yes |
Practice location
96 Campus DrScarborough, ME 04074-7163
Phone 207-885-9905
Mailing address
96 Campus DrScarborough, ME 04074-7163
Phone 207-885-9905
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