MEDICARE: ANGELIC HANDS HOUSE CALLS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124641709
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGELIC HANDS HOUSE CALLS

Provider Business Mailing Address
First Line	:	PO BOX 165
Second Line	:
City	:	CANTON
State	:	MS
Zip	:	39046-0165
Country	:	US
Telephone Number	:	601-906-0130
Fax Number	:	601-667-3508

Provider Business Practice Location Address
First Line	:	299 W PEACE ST STE B
Second Line	:
City	:	CANTON
State	:	MS
Zip	:	39046-4325
Country	:	US
Telephone Number	:	601-906-0130
Fax Number	:	601-667-3508

Authorized Official
Title or Position	:	FAMILY NURSE PRACTITIONER
Name	:	ANGELA JONES STEWART
Credential	:	FNPC
Telephone Number	:	601-906-0130

Provider Enumeration Date	:	05/18/2020
Last Update Date	:	05/18/2020

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Directions to “ANGELIC HANDS HOUSE CALLS ” Practice Location

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