Healthcare Provider Details

I. General information

NPI: 1700315744
Provider Name (Legal Business Name): ANGELA KATHRYN HON AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2017
Last Update Date: 07/27/2023
Certification Date: 07/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 PRINCETON AVE SW, STE 707
BIRMINGHAM AL
35211
US

IV. Provider business mailing address

801 PRINCETON AVE SW, STE 707
BIRMINGHAM AL
35211-1395
US

V. Phone/Fax

Practice location:
  • Phone: 205-327-7720
  • Fax: 205-780-7775
Mailing address:
  • Phone: 205-327-7720
  • Fax: 205-780-7775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1-126857
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number1-126857
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: