Provider Demographics
NPI:1851780365
Name:MUSSELMAN, ANGELINA (APRN NP-C)
Entity Type:Individual
Prefix:
First Name:ANGELINA
Middle Name:
Last Name:MUSSELMAN
Suffix:
Gender:F
Credentials:APRN NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 SUNRISE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROMNEY
Mailing Address - State:WV
Mailing Address - Zip Code:26757-4607
Mailing Address - Country:US
Mailing Address - Phone:304-822-4932
Mailing Address - Fax:304-822-4957
Practice Address - Street 1:10701 NEW GEORGES CREEK RD SW
Practice Address - Street 2:
Practice Address - City:FROSTBURG
Practice Address - State:MD
Practice Address - Zip Code:21532-1457
Practice Address - Country:US
Practice Address - Phone:301-689-3229
Practice Address - Fax:301-689-1129
Is Sole Proprietor?:No
Enumeration Date:2015-01-21
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN80560363LF0000X, 363L00000X
WV80560363LF0000X
MDAC002362363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD211828OtherFQHC MEDICARE
MD564003200Medicaid
WV3810029354Medicaid