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General NPI Number Information
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NPI Number | 1528599602
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Entity Type | Individual
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Provider Name | ANGELETTE NICHOL SYKES FNP
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Gender | Female
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Dates
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Enumeration Date | 03/21/2017
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Last Update Date | 03/21/2017
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Provider Practice Location Address
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Address Line | 10651 CALI CV
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City | OLIVE BRANCH
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State | MS
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Zip | 38654-9551
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Country | US
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Telephone | 901-210-3294
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Fax |
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Provider Business Mailing Address
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Address Line | 10651 CALI CV
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City | OLIVE BRANCH
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State | MS
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Zip | 38654-9551
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Country | US
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Telephone | 901-210-3294
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 22429
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License Number State | TN
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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 | 901751
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License Number State | MS
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