Provider Demographics
NPI:1720590565
Name:MARKLEY, ANGELA DECKER (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:DECKER
Last Name:MARKLEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MRS
Other - First Name:ANGELA
Other - Middle Name:DECKER
Other - Last Name:KERCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5545 WW KELLEY ROAD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32311
Mailing Address - Country:US
Mailing Address - Phone:850-728-6696
Mailing Address - Fax:
Practice Address - Street 1:365 HOLLY RD
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:FL
Practice Address - Zip Code:32344-1011
Practice Address - Country:US
Practice Address - Phone:850-728-6696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-02
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9248701363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology