Provider Demographics
NPI:1982138533
Name:MCDOWELL, ANGELIA (DNP, APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:ANGELIA
Middle Name:
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 VINCENT ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSDALE
Mailing Address - State:MS
Mailing Address - Zip Code:38614-4617
Mailing Address - Country:US
Mailing Address - Phone:662-347-4428
Mailing Address - Fax:
Practice Address - Street 1:1023 VINCENT ST
Practice Address - Street 2:
Practice Address - City:CLARKSDALE
Practice Address - State:MS
Practice Address - Zip Code:38614-4617
Practice Address - Country:US
Practice Address - Phone:662-347-4428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS901834363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health