Provider Demographics
NPI:1750665667
Name:HOLSEY, ANGELA MARIE (NP-C)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:HOLSEY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:MARIE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:550 PEACHTREE ST NE
Mailing Address - Street 2:SUITE 1600
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2212
Mailing Address - Country:US
Mailing Address - Phone:404-888-7575
Mailing Address - Fax:404-253-6896
Practice Address - Street 1:226 E COLLEGE ST
Practice Address - Street 2:SUITE B
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-4348
Practice Address - Country:US
Practice Address - Phone:678-987-1490
Practice Address - Fax:678-987-1491
Is Sole Proprietor?:No
Enumeration Date:2011-10-11
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN152873363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003116776AMedicaid
GA202I501696Medicare UPIN