Provider Demographics
NPI:1811763626
Name:HAYGOOD WALTON, ANGELA A
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:A
Last Name:HAYGOOD WALTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5459 MONTAINE AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-5488
Mailing Address - Country:US
Mailing Address - Phone:614-735-2005
Mailing Address - Fax:
Practice Address - Street 1:4911 INSPIRATION DR
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-9109
Practice Address - Country:US
Practice Address - Phone:419-747-4008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-01
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty