1972791903 NPI number — MS. ANGELA COLLEEN STOKES MSN, APRN-BC

Table of content: MS. ANGELA COLLEEN STOKES MSN, APRN-BC (NPI 1972791903)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972791903 NPI number — MS. ANGELA COLLEEN STOKES MSN, APRN-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STOKES
Provider First Name:
ANGELA
Provider Middle Name:
COLLEEN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSN, APRN-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WELLS
Provider Other First Name:
ANGELA
Provider Other Middle Name:
COLLEEN
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSN, APRN-BC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1972791903
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/12/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1805 INGLESIDE DRIVE,
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATHENS
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37303
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-745-8802
Provider Business Mailing Address Fax Number:
423-744-7064

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1805 INGLESIDE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATHENS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-745-8802
Provider Business Practice Location Address Fax Number:
423-744-7064
Provider Enumeration Date:
10/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X , with the licence number:  12952 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com