Provider Demographics
NPI:1184788572
Name:ANGELL, JAMES T (ANP)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:T
Last Name:ANGELL
Suffix:
Gender:M
Credentials:ANP
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Mailing Address - Street 1:6490 MOUNT MORIAH ROAD EXT
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115-3729
Mailing Address - Country:US
Mailing Address - Phone:901-565-0244
Mailing Address - Fax:901-565-0616
Practice Address - Street 1:6490 MOUNT MORIAH ROAD EXT
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-3729
Practice Address - Country:US
Practice Address - Phone:901-367-1001
Practice Address - Fax:901-565-0616
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2014-08-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARA01147 ANP363LA2200X
TNRN0000046481363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5W390Medicare ID - Type Unspecified
S19626Medicare UPIN