Provider Demographics
NPI:1316374689
Name:DEANGELO, ASHLEY M (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:M
Last Name:DEANGELO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:JANOKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:1800 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-2369
Practice Address - Country:US
Practice Address - Phone:570-703-4830
Practice Address - Fax:570-703-4835
Is Sole Proprietor?:No
Enumeration Date:2013-10-02
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN598066163W00000X
PASP013120363L00000X
PASP014049363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily