Provider Demographics
NPI:1477119659
Name:DAVIS, ANGELA KAY (RN-MSN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:KAY
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RN-MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5270 COUNTY ROAD 147
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:AL
Mailing Address - Zip Code:35983-4905
Mailing Address - Country:US
Mailing Address - Phone:256-523-8191
Mailing Address - Fax:
Practice Address - Street 1:1102 GOODYEAR AVE
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-2008
Practice Address - Country:US
Practice Address - Phone:256-492-9924
Practice Address - Fax:256-492-9965
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-14
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-136452163W00000X
AL0245286363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse