Provider Demographics
NPI:1689200180
Name:EVERINGHAM, ANGELICA (DNP, APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ANGELICA
Middle Name:
Last Name:EVERINGHAM
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:MISS
Other - First Name:ANGELICA
Other - Middle Name:
Other - Last Name:PERALTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3636 BARKIS AVE
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-2717
Mailing Address - Country:US
Mailing Address - Phone:561-704-0545
Mailing Address - Fax:
Practice Address - Street 1:3636 BARKIS AVE
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-2717
Practice Address - Country:US
Practice Address - Phone:561-704-0545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-16
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF01201812363LP2300X
FLAPRN11007646363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care