Healthcare Provider Details

I. General information

NPI: 1134877558
Provider Name (Legal Business Name): ANGELA PATRICE HALE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2022
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 SENTARA CIR STE 105
WILLIAMSBURG VA
23188-5754
US

IV. Provider business mailing address

6353 CENTER DR STE 100
NORFOLK VA
23502-4100
US

V. Phone/Fax

Practice location:
  • Phone: 757-253-5653
  • Fax: 757-378-2776
Mailing address:
  • Phone: 561-486-8439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number0024184641
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: