Provider Demographics
NPI:1154801454
Name:LLEWELLYN, ANGELA KAYE (NP, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:KAYE
Last Name:LLEWELLYN
Suffix:
Gender:F
Credentials:NP, FNP-C
Other - Prefix:MRS
Other - First Name:ANGELA
Other - Middle Name:KAYE
Other - Last Name:RICHARDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1109 BURLEYSON RD STE 104
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-3094
Mailing Address - Country:US
Mailing Address - Phone:706-281-8490
Mailing Address - Fax:706-529-8487
Practice Address - Street 1:1109 BURLEYSON RD STE 104
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-3094
Practice Address - Country:US
Practice Address - Phone:706-281-8490
Practice Address - Fax:706-529-8487
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN24474207Q00000X, 2084F0202X
GARN1952932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry