Provider Demographics
NPI:1518152552
Name:ANDINO, ANGELA KAY (RNC,WHCNP)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:KAY
Last Name:ANDINO
Suffix:
Gender:F
Credentials:RNC,WHCNP
Other - Prefix:MS
Other - First Name:ANGELA
Other - Middle Name:KAY
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RNC,WHCNP
Mailing Address - Street 1:7765 KELLY LYNN LN
Mailing Address - Street 2:
Mailing Address - City:WATAUGA
Mailing Address - State:TX
Mailing Address - Zip Code:76148-2434
Mailing Address - Country:US
Mailing Address - Phone:214-244-6133
Mailing Address - Fax:
Practice Address - Street 1:480 E MAIN ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:TX
Practice Address - Zip Code:75840-4313
Practice Address - Country:US
Practice Address - Phone:903-731-5261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX570878363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health