Healthcare Provider Details

I. General information

NPI: 1871806752
Provider Name (Legal Business Name): ANGELA SUE DARNELL M.S., C.G.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA SUE CRAWFORD

II. Dates (important events)

Enumeration Date: 07/20/2010
Last Update Date: 07/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1718 E 4TH ST STE 404
CHARLOTTE NC
28204-3193
US

IV. Provider business mailing address

11820 VILLAGE POND DR
CHARLOTTE NC
28278-7678
US

V. Phone/Fax

Practice location:
  • Phone: 704-384-5731
  • Fax:
Mailing address:
  • Phone: 704-587-3669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number12717
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: