Provider Demographics
NPI:1356001606
Name:DAVIS, ANGELA MEGAN (APRN, FNP-BC, NP-C)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MEGAN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:APRN, FNP-BC, NP-C
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:MEGAN
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:921 EAGLE RUN
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-0983
Mailing Address - Country:US
Mailing Address - Phone:304-685-9512
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26506-1200
Practice Address - Country:US
Practice Address - Phone:304-598-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-28
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV92355363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner