Provider Demographics
NPI:1417394875
Name:BURRELL, ANGELA F (FNP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:F
Last Name:BURRELL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:F
Other - Last Name:BEDGOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:5701 S HOOVER ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90037-4045
Mailing Address - Country:US
Mailing Address - Phone:323-541-1616
Mailing Address - Fax:
Practice Address - Street 1:5701 S HOOVER ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90037-4045
Practice Address - Country:US
Practice Address - Phone:323-541-1616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-25
Last Update Date:2013-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA498359163WC1600X
CA22790363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development