Healthcare Provider Details

I. General information

NPI: 1861923898
Provider Name (Legal Business Name): ANGELA MARIE MAJORS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA MARIE SULLIVAN FNP-BC

II. Dates (important events)

Enumeration Date: 03/22/2017
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 S 8TH ST
MURRAY KY
42071-2428
US

IV. Provider business mailing address

PO BOX 497
AUGUSTA AR
72006-0497
US

V. Phone/Fax

Practice location:
  • Phone: 270-753-2395
  • Fax: 270-759-4745
Mailing address:
  • Phone: 870-347-2534
  • Fax: 870-301-2092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number23369
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3011029
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: