Provider Demographics
NPI:1639450448
Name:FROST, ANGELENA (CNP)
Entity Type:Individual
Prefix:
First Name:ANGELENA
Middle Name:
Last Name:FROST
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 ENCINO PL NE
Mailing Address - Street 2:SUITE D5
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-2612
Mailing Address - Country:US
Mailing Address - Phone:505-242-5353
Mailing Address - Fax:505-242-9788
Practice Address - Street 1:801 ENCINO PL NE
Practice Address - Street 2:SUITE D5
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2612
Practice Address - Country:US
Practice Address - Phone:505-242-5353
Practice Address - Fax:505-242-9788
Is Sole Proprietor?:No
Enumeration Date:2011-09-07
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-01845363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily