Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | SP016682 | PA |
NPI | 1013469238 |
---|---|
Provider Name | Nancy Deangelis |
First Address | Willow Grove, PA 19090-1216 |
Second Address | Abington, PA 19001-3714 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2016 |
Last Update Date | 03/01/2017 |