Provider Demographics
NPI:1154643385
Name:SEALEY, ANGELA GRAY (CNA1)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:GRAY
Last Name:SEALEY
Suffix:
Gender:F
Credentials:CNA1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10434 HICKSBORO LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLESEX
Mailing Address - State:NC
Mailing Address - Zip Code:27557-8105
Mailing Address - Country:US
Mailing Address - Phone:252-366-0324
Mailing Address - Fax:
Practice Address - Street 1:10434 HICKSBORO LN
Practice Address - Street 2:
Practice Address - City:MIDDLESEX
Practice Address - State:NC
Practice Address - Zip Code:27557-8105
Practice Address - Country:US
Practice Address - Phone:252-366-0324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-15
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC348582376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide