Provider Demographics
NPI:1962653782
Name:SEALS, ANGELA (CRNP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:SEALS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1280 SUMMIT DRIVE
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501-0102
Mailing Address - Country:US
Mailing Address - Phone:205-387-7555
Mailing Address - Fax:205-384-9006
Practice Address - Street 1:1280 SUMMITT
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-0102
Practice Address - Country:US
Practice Address - Phone:205-387-7555
Practice Address - Fax:205-384-9006
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-084804363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner