Provider Demographics
NPI:1518557420
Name:RUBLEY, ANGELA E
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:E
Last Name:RUBLEY
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 1:375 RUCKER RD
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37127-6450
Mailing Address - Country:US
Mailing Address - Phone:615-648-5159
Mailing Address - Fax:
Practice Address - Street 1:300 STONECREST BLVD STE 250
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-6832
Practice Address - Country:US
Practice Address - Phone:615-223-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28889207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty