Provider Demographics
NPI:1578620506
Name:D'ANGELO, CHERRY ANN (CRNP, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:CHERRY
Middle Name:ANN
Last Name:D'ANGELO
Suffix:
Gender:F
Credentials:CRNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3820 BRIDGES ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-2978
Mailing Address - Country:US
Mailing Address - Phone:252-648-3124
Mailing Address - Fax:
Practice Address - Street 1:3820 BRIDGES ST
Practice Address - Street 2:SUITE B
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-2978
Practice Address - Country:US
Practice Address - Phone:252-648-3124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
PASP009534363LA2200X
PASP010882363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health