Provider Demographics
NPI:1235609074
Name:HEAD2TOE HEALTH
Entity Type:Organization
Organization Name:HEAD2TOE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEIRDRE
Authorized Official - Middle Name:F
Authorized Official - Last Name:ANGELASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:301-337-8610
Mailing Address - Street 1:806 AMBER TREE CT APT 301
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-5207
Mailing Address - Country:US
Mailing Address - Phone:240-388-5757
Mailing Address - Fax:
Practice Address - Street 1:4938 SAINT ELMO AVE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-6008
Practice Address - Country:US
Practice Address - Phone:301-337-8610
Practice Address - Fax:301-337-8621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR209417OtherMD LICENSE
MDMA4473435OtherDEA