Provider Demographics
NPI:1902542137
Name:WILSON, ANGELA OAKLEY (CRNP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:OAKLEY
Last Name:WILSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MISS
Other - First Name:ANGELA
Other - Middle Name:JEAN
Other - Last Name:OAKLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2100 CORNER RD
Mailing Address - Street 2:
Mailing Address - City:WARRIOR
Mailing Address - State:AL
Mailing Address - Zip Code:35180-2703
Mailing Address - Country:US
Mailing Address - Phone:205-353-5476
Mailing Address - Fax:
Practice Address - Street 1:801 PRINCETON AVE SW STE 707
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1395
Practice Address - Country:US
Practice Address - Phone:205-780-4330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-073777363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily