Healthcare Provider Details

I. General information

NPI: 1578720231
Provider Name (Legal Business Name): ANGELA STERLING NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 01/11/2021
Certification Date: 01/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

970 LAKELAND DR SUITE 61
JACKSON MS
39216-4635
US

IV. Provider business mailing address

970 LAKELAND DR SUITE 61
JACKSON MS
39216-4635
US

V. Phone/Fax

Practice location:
  • Phone: 601-982-7850
  • Fax: 601-718-5145
Mailing address:
  • Phone: 601-982-7850
  • Fax: 601-718-5145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR850686
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: