Provider Demographics
NPI:1497419378
Name:JAMES, TANGELA (LPN)
Entity Type:Individual
Prefix:
First Name:TANGELA
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3515 PLEASANTDALE RD APT 285
Mailing Address - Street 2:
Mailing Address - City:DORAVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30340-5673
Mailing Address - Country:US
Mailing Address - Phone:470-851-5610
Mailing Address - Fax:
Practice Address - Street 1:3515 PLEASANTDALE RD APT 285
Practice Address - Street 2:
Practice Address - City:DORAVILLE
Practice Address - State:GA
Practice Address - Zip Code:30340-5673
Practice Address - Country:US
Practice Address - Phone:470-851-5610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN059466164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse