Individual
ANGELA DELOACH CHUMLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
241 SILVERWOOD COMMERCIAL DR, RINCON, GA 31326
(912) 826-8800
(912) 826-8803
Mailing address
241 SILVERWOOD COMMERCIAL DR, RINCON, GA 31326-5164
(912) 826-8800
(912) 826-8803
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN085064
GA
363LF0000X
Family Nurse Practitioner
Primary
RN085064
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01067480
AMERIGROUP
GA
01
—
404169
WELLCARE
GA
01
—
50BBJPZ
OLD MEDICARE PTAN - TERM'D 10/17/06 FOR NON-BILLING
GA
05
—
554311133A
—
GA
01
—
P00853754
RR MEDICARE
GA
Enumeration date
06/22/2006
Last updated
08/06/2018
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