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NPI Code Detail

MEDICARE: MS. ANGELA FAYE WOODLEY-WILLIAMS RN, NP-C

MEDICARE: MS. ANGELA FAYE WOODLEY-WILLIAMS RN, NP-C
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
1363LP2300XPrimary Care Nurse Practitioner4704157534MI

General Provider Information

NPI Number : 1861624058
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANGELA FAYE WOODLEY-WILLIAMS RN, NP-C
Provider Business Mailing Address
First Line : 30 W MONROE ST STE 1200
Second Line :
City : CHICAGO
State : IL
Zip : 60603-2420
Country : US
Telephone Number : 312-733-9730
Fax Number : 773-866-8014
Provider Business Practice Location Address
First Line : 11260 E JEFFERSON AVE
Second Line :
City : DETROIT
State : MI
Zip : 48214-3320
Country : US
Telephone Number : 313-749-0148
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2009
Last Update Date : 05/18/2020

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