Provider Demographics
NPI:1124645940
Name:GREEN, ZANGELA
Entity type:Individual
Prefix:
First Name:ZANGELA
Middle Name:
Last Name:GREEN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:ZANGELA
Other - Middle Name:
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:501 W SMITHFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:DOLOMITE
Mailing Address - State:AL
Mailing Address - Zip Code:35061-1043
Mailing Address - Country:US
Mailing Address - Phone:205-808-6381
Mailing Address - Fax:
Practice Address - Street 1:501 W SMITHFIELD CIR
Practice Address - Street 2:
Practice Address - City:DOLOMITE
Practice Address - State:AL
Practice Address - Zip Code:35061-1043
Practice Address - Country:US
Practice Address - Phone:205-796-8752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-26
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL174200000X, 251E00000X, 347C00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No174200000XOther Service ProvidersMeals
No251E00000XAgenciesHome Health
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL851491955OtherEIN FOR BUSINESS