Provider Demographics
NPI:1093817306
Name:FURR, ANGELA (CFNP)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:
Last Name:FURR
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:MS
Mailing Address - Zip Code:38851-9326
Mailing Address - Country:US
Mailing Address - Phone:662-456-3437
Mailing Address - Fax:662-456-2070
Practice Address - Street 1:208 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:MS
Practice Address - Zip Code:38851-9326
Practice Address - Country:US
Practice Address - Phone:662-456-3437
Practice Address - Fax:662-456-2070
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR850534363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00118979Medicaid
MS500001436Medicare ID - Type Unspecified
MS500001436Medicare Oscar/Certification
Q08502Medicare Oscar/Certification
MS00118979Medicaid