Basic Information
| Provider Information | |||||||||
| NPI: | 1427226026 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCDOWELL | ||||||||
| FirstName: | ANGELA | ||||||||
| MiddleName: | JOY | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 217 RIVER VALLEY TRL | ||||||||
| Address2: | |||||||||
| City: | KATHLEEN | ||||||||
| State: | GA | ||||||||
| PostalCode: | 310472135 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4782188745 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5398 THOMASTON RD STE B | ||||||||
| Address2: | |||||||||
| City: | MACON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 312208110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4784768868 | ||||||||
| FaxNumber: | 4784768161 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2008 | ||||||||
| LastUpdateDate: | 02/15/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WA2000X | RN118171 | GA | Y | Nursing Service Providers | Registered Nurse | Administrator |
No ID Information.