Provider Demographics
NPI:1306468699
Name:KILGORE, ANGELA ANN (NP)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:ANN
Last Name:KILGORE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:ANGELA
Other - Middle Name:ANN
Other - Last Name:EDELEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:8168 HWY 77
Mailing Address - Street 2:
Mailing Address - City:SINTON
Mailing Address - State:TX
Mailing Address - Zip Code:78387-9746
Mailing Address - Country:US
Mailing Address - Phone:361-364-2804
Mailing Address - Fax:361-364-5014
Practice Address - Street 1:8168 HWY 77
Practice Address - Street 2:
Practice Address - City:SINTON
Practice Address - State:TX
Practice Address - Zip Code:78387-9746
Practice Address - Country:US
Practice Address - Phone:361-364-2804
Practice Address - Fax:361-364-5014
Is Sole Proprietor?:No
Enumeration Date:2020-05-11
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP146020363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily