Provider Demographics
NPI:1356095186
Name:RITCHIE, ANGEL VICTORIA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:VICTORIA
Last Name:RITCHIE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:ANGEL
Other - Middle Name:VICTORIA
Other - Last Name:VANCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:92 WILLIAMSON ST
Mailing Address - Street 2:
Mailing Address - City:RAVENSWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26164-9651
Mailing Address - Country:US
Mailing Address - Phone:304-928-4602
Mailing Address - Fax:
Practice Address - Street 1:3200 MACCORKLE AVE SE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1227
Practice Address - Country:US
Practice Address - Phone:304-388-4172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV85728163W00000X
WV111994363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse