Provider Demographics
NPI:1598521213
Name:LOFTON-VARNADO, ANGELA FRANCSHON (AGACNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:FRANCSHON
Last Name:LOFTON-VARNADO
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 MARION AVE
Mailing Address - Street 2:
Mailing Address - City:MCCOMB
Mailing Address - State:MS
Mailing Address - Zip Code:39648-2010
Mailing Address - Country:US
Mailing Address - Phone:601-341-3399
Mailing Address - Fax:
Practice Address - Street 1:111 MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:MS
Practice Address - Zip Code:39652-2825
Practice Address - Country:US
Practice Address - Phone:601-783-2374
Practice Address - Fax:601-783-5126
Is Sole Proprietor?:No
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS906225363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology