Provider Demographics
NPI:1306170923
Name:ANGHELACHE, COCA (CNP)
Entity type:Individual
Prefix:MISS
First Name:COCA
Middle Name:
Last Name:ANGHELACHE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6611 CLYO RD
Mailing Address - Street 2:STE E
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-2785
Mailing Address - Country:US
Mailing Address - Phone:937-886-9191
Mailing Address - Fax:
Practice Address - Street 1:6611 CLYO RD STE E
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-2785
Practice Address - Country:US
Practice Address - Phone:937-208-8282
Practice Address - Fax:937-208-8275
Is Sole Proprietor?:No
Enumeration Date:2009-09-29
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.10993-NP363LF0000X
OHRX.10993-EX1363LF0000X
OHRN 315385363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily