Provider Demographics
NPI:1275601742
Name:NABORS, ANGELA L
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:L
Last Name:NABORS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 602
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:AL
Mailing Address - Zip Code:36250-0602
Mailing Address - Country:US
Mailing Address - Phone:256-892-8897
Mailing Address - Fax:
Practice Address - Street 1:614 PELHAM RD S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:AL
Practice Address - Zip Code:36265-2732
Practice Address - Country:US
Practice Address - Phone:256-435-5502
Practice Address - Fax:256-435-5797
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL42416OtherBLUE CROSS