Provider Demographics
NPI:1659608735
Name:WHATLEY, ANGELA R (RN CERT LABOR DOULA)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:R
Last Name:WHATLEY
Suffix:
Gender:F
Credentials:RN CERT LABOR DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12718 STATE HIGHWAY 118
Mailing Address - Street 2:
Mailing Address - City:TYRONZA
Mailing Address - State:AR
Mailing Address - Zip Code:72386-8984
Mailing Address - Country:US
Mailing Address - Phone:870-636-5231
Mailing Address - Fax:870-735-5816
Practice Address - Street 1:200 W TYLER AVE
Practice Address - Street 2:
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-4223
Practice Address - Country:US
Practice Address - Phone:870-735-5527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-10
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR41550374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula