Provider Demographics
NPI:1932700184
Name:COLON, ANGELA DAMON (RN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:DAMON
Last Name:COLON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 MORNING DOVE CT
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-2919
Mailing Address - Country:US
Mailing Address - Phone:904-209-6587
Mailing Address - Fax:
Practice Address - Street 1:1221 MORNING DOVE CT
Practice Address - Street 2:
Practice Address - City:SAINT JOHNS
Practice Address - State:FL
Practice Address - Zip Code:32259-2919
Practice Address - Country:US
Practice Address - Phone:904-209-6587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9333302163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse