Provider Demographics
NPI:1558775023
Name:TEAGUE-PRIDDY, ANGELIA HICKS (NP)
Entity Type:Individual
Prefix:
First Name:ANGELIA
Middle Name:HICKS
Last Name:TEAGUE-PRIDDY
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 1:7865 JEFFERSON HWY STE D
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-1384
Mailing Address - Country:US
Mailing Address - Phone:225-529-2207
Mailing Address - Fax:225-529-2264
Practice Address - Street 1:7865 JEFFERSON HWY STE D
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-1384
Practice Address - Country:US
Practice Address - Phone:225-529-2207
Practice Address - Fax:225-529-2264
Is Sole Proprietor?:No
Enumeration Date:2014-06-12
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR878930363L00000X
LAAP092932084P0804X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry