Basic Information
| Provider Information | |||||||||
| NPI: | 1629418439 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WARREN | ||||||||
| FirstName: | ANGELA | ||||||||
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| Credential: | FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5041 CORPORATE WOODS DR | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | VIRGINIA BEACH | ||||||||
| State: | VA | ||||||||
| PostalCode: | 234624375 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7574909323 | ||||||||
| FaxNumber: | 7574904519 | ||||||||
| Practice Location | |||||||||
| Address1: | 5041 CORPORATE WOODS DR | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | VIRGINIA BEACH | ||||||||
| State: | VA | ||||||||
| PostalCode: | 234624375 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7574909323 | ||||||||
| FaxNumber: | 7574904519 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2013 | ||||||||
| LastUpdateDate: | 10/30/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 28176997A | IN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.