Provider Demographics
NPI:1477702728
Name:SALE, ANGELA DECARLA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:DECARLA
Last Name:SALE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 CARMEL RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-6150
Mailing Address - Country:US
Mailing Address - Phone:704-542-9210
Mailing Address - Fax:
Practice Address - Street 1:4100 CARMEL RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-6150
Practice Address - Country:US
Practice Address - Phone:704-542-9210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5010301363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200932140Medicaid
INP00737275OtherRAILROAD INDIVIDUAL
IN71002719AOtherNP LICENSURE
INCA6833OtherRAILROAD GROUP
IN232230RRRRMedicare PIN
IN71002719AOtherNP LICENSURE