Provider Demographics
NPI:1457683740
Name:BORRELL, ANGELA (CRNP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:BORRELL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11312 MANKLIN CREEK RD UNIT 5
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:MD
Mailing Address - Zip Code:21811-4009
Mailing Address - Country:US
Mailing Address - Phone:443-513-5000
Mailing Address - Fax:888-307-9020
Practice Address - Street 1:11312 MANKLIN CREEK RD UNIT 5
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811-4009
Practice Address - Country:US
Practice Address - Phone:443-513-0500
Practice Address - Fax:888-307-9020
Is Sole Proprietor?:No
Enumeration Date:2010-02-11
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR212707163WA0400X, 363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1497390702OtherTYPE II NPI