Provider Demographics
NPI:1255173134
Name:ANGEL, VICTORIA MICHELLE (APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:MICHELLE
Last Name:ANGEL
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 WILLOW CREEK RD STE C
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-1645
Mailing Address - Country:US
Mailing Address - Phone:928-362-0577
Mailing Address - Fax:928-916-5441
Practice Address - Street 1:1000 WILLOW CREEK RD STE C
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-1645
Practice Address - Country:US
Practice Address - Phone:928-362-0577
Practice Address - Fax:928-916-5441
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-11
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ221248163WH1000X, 3336C0002X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No3336C0002XSuppliersPharmacyClinic Pharmacy