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General NPI Number Information
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NPI Number | 1417131327
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Entity Type | Individual
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Provider Name | JINGLE A ANGELES PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 25228 LANKFORD HIGHWAY
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City | ONLEY
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State | VA
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Zip | 23418
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Country | US
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Telephone | 757-787-1465
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Fax |
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Provider Business Mailing Address
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Address Line | 55 MAUI LANI PKWY
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City | WAILUKU
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State | HI
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Zip | 96793-2416
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Country | US
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Telephone | 808-243-6050
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 012333-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110010429
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00193000
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | AMD-1026
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License Number State | HI
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