Provider Demographics
NPI:1013369032
Name:JOEL, ANGEL KARISMA (CERTIFIED NURSE AID)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:KARISMA
Last Name:JOEL
Suffix:
Gender:F
Credentials:CERTIFIED NURSE AID
Other - Prefix:
Other - First Name:ANGEL
Other - Middle Name:KARISMA UDOCHI
Other - Last Name:AZUBIKE-JOEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4 COURAGE LN
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-4843
Mailing Address - Country:US
Mailing Address - Phone:703-364-8644
Mailing Address - Fax:
Practice Address - Street 1:28 COURAGE LN
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-4844
Practice Address - Country:US
Practice Address - Phone:703-364-8644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-01
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1401137134171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor