Provider Demographics
NPI:1295302602
Name:FRIEND, ANGELA ROSE (FNP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:ROSE
Last Name:FRIEND
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24300 PERIMETER RD
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:VA
Mailing Address - Zip Code:22427-2821
Mailing Address - Country:US
Mailing Address - Phone:210-237-8762
Mailing Address - Fax:
Practice Address - Street 1:621 JEFFERSON DAVIS HWY STE 201
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4567
Practice Address - Country:US
Practice Address - Phone:540-372-2028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-06
Last Update Date:2021-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024181525363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily