Provider Demographics
NPI:1689359952
Name:ARMSTRONG, AZELL JR (CNA)
Entity type:Individual
Prefix:
First Name:AZELL
Middle Name:
Last Name:ARMSTRONG
Suffix:JR
Gender:M
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2962 KNOLL VIEW PL
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-8638
Mailing Address - Country:US
Mailing Address - Phone:310-933-2033
Mailing Address - Fax:
Practice Address - Street 1:2962 KNOLL VIEW PL
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-8638
Practice Address - Country:US
Practice Address - Phone:310-933-2033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACN0030086686376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide