Provider Demographics
NPI:1780396317
Name:JOHNS, ANGELA (RN, BSN, CCM)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:
Last Name:JOHNS
Suffix:
Gender:F
Credentials:RN, BSN, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 VESTAVIA PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35216-3756
Mailing Address - Country:US
Mailing Address - Phone:205-823-2810
Mailing Address - Fax:
Practice Address - Street 1:600 VESTAVIA PKWY STE 200
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35216-3756
Practice Address - Country:US
Practice Address - Phone:205-823-2810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-095105163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management