Provider Demographics
NPI:1912007469
Name:CURSEY, ANGELA B (NURSE PRACT)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:B
Last Name:CURSEY
Suffix:
Gender:F
Credentials:NURSE PRACT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 HAWKS RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:MARTIN
Mailing Address - State:TN
Mailing Address - Zip Code:38237-2708
Mailing Address - Country:US
Mailing Address - Phone:731-587-3454
Mailing Address - Fax:731-587-3460
Practice Address - Street 1:215 HAWKS RD
Practice Address - Street 2:SUITE 6
Practice Address - City:MARTIN
Practice Address - State:TN
Practice Address - Zip Code:38237-2708
Practice Address - Country:US
Practice Address - Phone:731-587-3454
Practice Address - Fax:731-587-3460
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN106601363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3902729Medicaid
TN3902729Medicaid
TN3902729Medicare ID - Type Unspecified