Provider Demographics
NPI:1730356536
Name:ALSTON, ANGELA D (NP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:D
Last Name:ALSTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:677 COOPER RD
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-8962
Mailing Address - Country:US
Mailing Address - Phone:614-776-4379
Mailing Address - Fax:614-569-2257
Practice Address - Street 1:393 E TOWN ST
Practice Address - Street 2:SUITE 226
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215
Practice Address - Country:US
Practice Address - Phone:614-566-9989
Practice Address - Fax:614-566-8423
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-09155363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2873234Medicaid
OH2873234Medicaid