Waller, Angela O

Waller, Angela O is an individual health care provider with primary practice located at 300 Highland Blvd Suite B, Natchez MS 39120-4600. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Waller, Angela O can be contacted via phone (601) 304-2421.

Contact Information

Primary practice address
300 Highland Blvd Suite B Natchez MS 39120-4600
Phone: (601) 304-2421
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X AP04732 Louisiana
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R853759 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X CNP65978 New Mexico

Profile Details

NPI number 1194774190
LBN Legal business name Waller, Angela O
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 8th, 2006
Last updated Jan 10th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1194774190 NPPES
Louisiana MEDICAID 1343447
Louisiana MEDICAID 04705271

Popular Providers