| Doctor Name: | ANGELA DEYONG |
| NPI Number: | 1326480344 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | ARNP9300931 |
| Business Practice Address: | 1045 Us Highway 331 S Ste D & E Defuniak Springs, FL - 324353379 |
| Business Phone Number: | 8506892336 |
| Business Fax Number: | |
| Mailing Address: | 1045 Us Highway 331 S, Ste D & E DEFUNIAK SPRINGS |
| State: | FL |
| Postal Code: | 324353379 |
| Phone Number: | 8506892336 |
| Fax Number: | |
| NPI Enumeration Date: | 07/18/2013 |
| NPI Last Update Date: | 10/15/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | ARNP9300931 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |