| Doctor Name: | ANGELIQUE MAHFOOD |
| NPI Number: | 1336382969 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.N. |
| License Number: | 117357 |
| Business Practice Address: | 520 S Elm Ave Webster Groves, MO - 631193845 |
| Business Phone Number: | 3149623464 |
| Business Fax Number: | |
| Mailing Address: | 6569 Suson Woods Dr, SAINT LOUIS |
| State: | MO |
| Postal Code: | 631284529 |
| Phone Number: | 3149623464 |
| Fax Number: | |
| NPI Enumeration Date: | 04/13/2009 |
| NPI Last Update Date: | 04/13/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP2201X |
| License Number: | 117357 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Ambulatory Care |
| Taxonomy Definition: | |