Provider Demographics
NPI:1003251612
Name:CAIN, ANGELA JO (APRN, PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:JO
Last Name:CAIN
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:JO
Other - Last Name:FERRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1374 HIGHWAY 192 E STE 400
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741-3123
Mailing Address - Country:US
Mailing Address - Phone:606-770-5454
Mailing Address - Fax:606-770-5455
Practice Address - Street 1:1374 HIGHWAY 192 E STE 400
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-3123
Practice Address - Country:US
Practice Address - Phone:606-770-5454
Practice Address - Fax:606-770-5455
Is Sole Proprietor?:No
Enumeration Date:2013-05-09
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3012229363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health