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General NPI Number Information
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NPI Number | 1003312257
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Entity Type | Individual
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Provider Name | ANGELA SHERRELL DANFORTH
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Gender | Female
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Dates
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Enumeration Date | 04/04/2018
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 5220 JIMMY LEE SMITH PARKWAY SUITE 104 #346
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City | HIRAM
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State | GA
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Zip | 30141-2853
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Country | US
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Telephone | 470-616-0086
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Fax | 213-319-6947
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Provider Business Mailing Address
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Address Line | 5220 JIMMY LEE SMITH PARKWAY SUITE 104 #346
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City | HIRAM
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State | GA
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Zip | 30141-2853
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Country | US
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Telephone | 470-616-0086
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Fax | 213-319-6947
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN247888
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 837214-01
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 61246611
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN247888
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN247888
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License Number State | GA
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