MEDICARE: MRS. ANGELA GAIL MERRELL N.P.-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
1	363LP2300X	Primary Care Nurse Practitioner	RN107436	GA

General Provider Information

NPI Number	:	1912364423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANGELA GAIL MERRELL N.P.-C

Provider Business Mailing Address
First Line	:	105 ENTERPRISE CT
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-3600
Country	:	US
Telephone Number	:	706-317-2673
Fax Number	:	706-317-2122

Provider Business Practice Location Address
First Line	:	105 ENTERPRISE CT
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-3600
Country	:	US
Telephone Number	:	706-317-2673
Fax Number	:	706-317-2122

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

Provider Enumeration Date	:	01/28/2016
Last Update Date	:	03/03/2026

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