Provider Demographics
NPI:1144083866
Name:LADNER, ANGEL DENAY (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:ANGEL
Middle Name:DENAY
Last Name:LADNER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ANGEL
Other - Middle Name:DENAY
Other - Last Name:WAYLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:1423 MAGNOLIA ST APT I
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39507-3569
Mailing Address - Country:US
Mailing Address - Phone:228-240-8833
Mailing Address - Fax:601-228-8415
Practice Address - Street 1:1423 MAGNOLIA ST APT I
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39507-3569
Practice Address - Country:US
Practice Address - Phone:228-240-8833
Practice Address - Fax:601-228-8415
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS906499363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily