Provider Demographics
NPI:1922718204
Name:STRIPLING, ANGERENTHEA COOKIE (CERTIFIED PHLEBOTOMY)
Entity Type:Individual
Prefix:MS
First Name:ANGERENTHEA
Middle Name:COOKIE
Last Name:STRIPLING
Suffix:
Gender:F
Credentials:CERTIFIED PHLEBOTOMY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:866 RIDGE AVE NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-8306
Mailing Address - Country:US
Mailing Address - Phone:404-759-4325
Mailing Address - Fax:
Practice Address - Street 1:866 RIDGE AVE NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-8306
Practice Address - Country:US
Practice Address - Phone:404-759-4325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA920326837405300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes405300000XOther Service ProvidersPrevention Professional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA92-0326837Medicaid
92-0326837OtherAETNA, CIGNA, AMBETTER, UHC, OSCAR, AND ETC