Basic Information
| Provider Information | |||||||||
| NPI: | 1841680915 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NOVAS | ||||||||
| FirstName: | ANGELA | ||||||||
| MiddleName: | LEAH | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19745 EXECUTIVE PARK CIR | ||||||||
| Address2: | |||||||||
| City: | GERMANTOWN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208742642 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3019466623 | ||||||||
| FaxNumber: | 3019461107 | ||||||||
| Practice Location | |||||||||
| Address1: | 19745 EXECUTIVE PARK CIRCLE | ||||||||
| Address2: | ADVANCED MEDICAL CARE | ||||||||
| City: | GERMANTOWN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 20874 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3015409447 | ||||||||
| FaxNumber: | 3019461107 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/28/2015 | ||||||||
| LastUpdateDate: | 07/28/2015 | ||||||||
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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 | 363LA2200X | R186282 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.