Provider Demographics
NPI:1235605684
Name:FERRARI-WALCZAK, ANGELA LYNN (CRNP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:LYNN
Last Name:FERRARI-WALCZAK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7646 COACHLIGHT LN UNIT A
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-7942
Mailing Address - Country:US
Mailing Address - Phone:443-629-6982
Mailing Address - Fax:
Practice Address - Street 1:7600 OSLER DR STE 200
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7701
Practice Address - Country:US
Practice Address - Phone:410-321-8452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-23
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR191750363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health