Provider Demographics
NPI:1265015085
Name:HOUCK, ANGELA G (NP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:G
Last Name:HOUCK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:150 MONUMENT RD STE 300
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1725
Mailing Address - Country:US
Mailing Address - Phone:610-747-3400
Mailing Address - Fax:610-617-2481
Practice Address - Street 1:150 MONUMENT RD STE 300
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1725
Practice Address - Country:US
Practice Address - Phone:610-747-3400
Practice Address - Fax:610-617-2481
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-29
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP023505363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology