Provider Demographics
NPI:1760264543
Name:DEMARCO, ANGELINA ROSE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ANGELINA
Middle Name:ROSE
Last Name:DEMARCO
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 GARDER RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:CT
Mailing Address - Zip Code:06468-1311
Mailing Address - Country:US
Mailing Address - Phone:203-214-9862
Mailing Address - Fax:
Practice Address - Street 1:280 GARDER RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:CT
Practice Address - Zip Code:06468-1311
Practice Address - Country:US
Practice Address - Phone:203-214-9862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12503363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily