Provider Demographics
NPI:1497252266
Name:ATANGCHO, FLORA (NP)
Entity Type:Individual
Prefix:
First Name:FLORA
Middle Name:
Last Name:ATANGCHO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 BLUEBILL DR
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-8931
Mailing Address - Country:US
Mailing Address - Phone:301-346-5378
Mailing Address - Fax:
Practice Address - Street 1:1181 PADDOCK RD
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:DE
Practice Address - Zip Code:19977-9679
Practice Address - Country:US
Practice Address - Phone:302-653-9261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-09
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0001122363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily