Provider Demographics
NPI:1104216019
Name:INGLE, ANGEL (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ANGEL
Middle Name:
Last Name:INGLE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 NICOLE TRL
Mailing Address - Street 2:
Mailing Address - City:HAYDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35079-5960
Mailing Address - Country:US
Mailing Address - Phone:205-789-6657
Mailing Address - Fax:
Practice Address - Street 1:645 NICOLE TRL
Practice Address - Street 2:
Practice Address - City:HAYDEN
Practice Address - State:AL
Practice Address - Zip Code:35079-5960
Practice Address - Country:US
Practice Address - Phone:205-789-6657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-29
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-106381363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily