Provider Demographics
NPI:1508645615
Name:MCPHILLIPS, ANGELA M (DNP, RN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:MCPHILLIPS
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Gender:F
Credentials:DNP, RN
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Mailing Address - Street 1:13293 DARNELL AVE
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33981-6125
Mailing Address - Country:US
Mailing Address - Phone:737-844-3346
Mailing Address - Fax:
Practice Address - Street 1:13293 DARNELL AVE
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33981-6125
Practice Address - Country:US
Practice Address - Phone:737-844-3346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-27
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLRN9641241163WC1500X, 222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health