Provider Demographics
NPI:1265034623
Name:PETROUS, ANGELICA NICOLINA FERRAZZI (DNP, APRN, AGPCNP-BC)
Entity type:Individual
Prefix:
First Name:ANGELICA
Middle Name:NICOLINA FERRAZZI
Last Name:PETROUS
Suffix:
Gender:
Credentials:DNP, APRN, AGPCNP-BC
Other - Prefix:
Other - First Name:ANGELICA
Other - Middle Name:NICOLINA
Other - Last Name:FERRAZZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, APRN, AGPCNP-BC
Mailing Address - Street 1:7503 SURRATTS RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-3358
Mailing Address - Country:US
Mailing Address - Phone:301-877-4673
Mailing Address - Fax:301-235-3381
Practice Address - Street 1:7503 SURRATTS RD STE 101
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-3358
Practice Address - Country:US
Practice Address - Phone:301-877-4673
Practice Address - Fax:301-235-3381
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-11
Last Update Date:2025-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1030205363LA2200X, 363LG0600X, 363LP2300X
MDAC003509363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care