MEDICARE: ANGELA JOY MCDOWELL RN

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	163WA2000X	Administrator Registered Nurse	RN118171	GA

General Provider Information

NPI Number	:	1427226026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA JOY MCDOWELL RN

Provider Business Mailing Address
First Line	:	217 RIVER VALLEY TRL
Second Line	:
City	:	KATHLEEN
State	:	GA
Zip	:	31047-2135
Country	:	US
Telephone Number	:	478-218-8745
Fax Number	:

Provider Business Practice Location Address
First Line	:	5398 THOMASTON RD STE B
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31220-8110
Country	:	US
Telephone Number	:	478-476-8868
Fax Number	:	478-476-8161

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2008
Last Update Date	:	02/15/2008

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