NPI 1124987664

Angela Evette Nicholas

Practitioner Private Vehicle Jonesboro, GA

Practice location

Address: 1909 Summercourt Dr Bldg 19, Jonesboro, GA 30236-1525
Phone: (404) 820-8100

Registered specialties

Private Vehicle Primary

Transportation Services Taxonomy 347C00000X Licence 055633269 (GA)

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Registry record

NPI: 1124987664
Entity type: Individual
Sex (as registered): Female
NPI issued: 20 Jan 2026
Record last updated: 20 Jan 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.