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Contact Information

ANGELA HARLESS, FNP
4 SHERIDAN SQ STE 200
KINGSPORT, TN37660-7435
 Phone: 423-246-7931
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

General Practice

163WG0000X
Indicates primary specialty

NPI Profile & details for ANGELA HARLESS · (Female)

NPI # 1962020750
Status Active
Credentials FNP (Family Nurse Practitioner)
Entity Individual
Enumeration date 07/08/2020
Last updated 01/17/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • TN License # 224683
  • TN License # 27946
  • TN Medicaid Q059857
Hospital affiliation(s)
  • WELLMONT HOLSTON VALLEY MEDICAL CENTER - (Acute Care)
    130 WEST RAVINE ROAD
    KINGSPORT, TN 37662
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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