Provider Demographics
NPI:1093437824
Name:SPEARS, ANGELA (REGISTERED NURSE)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:
Last Name:SPEARS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3508 NEAL CT
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-8409
Mailing Address - Country:US
Mailing Address - Phone:703-505-1274
Mailing Address - Fax:
Practice Address - Street 1:3508 NEAL CT
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-8409
Practice Address - Country:US
Practice Address - Phone:703-505-1274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1001819163WP0808X, 363LP0200X
VA0024185832363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health