Provider Demographics
NPI:1639443146
Name:NOWELL, ANGELA D (ARNP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:D
Last Name:NOWELL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:D
Other - Last Name:NOWELL BLANCHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:2700 WEST PLEASANT RUN ROAD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146
Mailing Address - Country:US
Mailing Address - Phone:469-857-5439
Mailing Address - Fax:469-857-5444
Practice Address - Street 1:2700 WEST PLEASANT RUN ROAD
Practice Address - Street 2:SUITE 300
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146
Practice Address - Country:US
Practice Address - Phone:469-857-5439
Practice Address - Fax:469-857-5444
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-01
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3178092363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3692956Medicaid