Provider Demographics
NPI:1205197548
Name:WILLIAMS, ANGELA N (RN)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:N
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2286 PRINCE CT
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-2070
Mailing Address - Country:US
Mailing Address - Phone:478-491-3047
Mailing Address - Fax:888-345-2624
Practice Address - Street 1:2286 PRINCE CT
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-2070
Practice Address - Country:US
Practice Address - Phone:478-491-3047
Practice Address - Fax:888-345-2624
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN202439163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice