Provider Demographics
NPI:1770261265
Name:HOWARD, ANGELA DAWN (FNP-C)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:DAWN
Last Name:HOWARD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 CRUISER DR
Mailing Address - Street 2:
Mailing Address - City:TUNNEL HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30755-9295
Mailing Address - Country:US
Mailing Address - Phone:762-201-2110
Mailing Address - Fax:
Practice Address - Street 1:777 UNDERWOOD DR
Practice Address - Street 2:
Practice Address - City:TRION
Practice Address - State:GA
Practice Address - Zip Code:30753-1500
Practice Address - Country:US
Practice Address - Phone:706-857-0514
Practice Address - Fax:706-857-0624
Is Sole Proprietor?:No
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN153623363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily