Provider Demographics
NPI:1982303905
Name:MOHR, ANGELA (ARNP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:MOHR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7325 W DESCHUTES AVE STE D
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-6705
Mailing Address - Country:US
Mailing Address - Phone:509-940-3376
Mailing Address - Fax:509-593-1813
Practice Address - Street 1:7325 W DESCHUTES AVE STE D
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-6705
Practice Address - Country:US
Practice Address - Phone:509-940-3376
Practice Address - Fax:509-593-1813
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61410001363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner