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Individual

ANGELA HARLESS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
4 SHERIDAN SQ STE 200, KINGSPORT, TN 37660-7435
(423) 246-7931
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
224683
TN
363LF0000X
Family Nurse Practitioner
Primary
27946
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Q059857
TN
Enumeration date
07/08/2020
Last updated
01/17/2024
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