Provider Demographics
NPI:1649800699
Name:DUBBS, ANGELA (DNP-FNP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:DUBBS
Suffix:
Gender:F
Credentials:DNP-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 ELM ST APT 4004
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75202-2925
Mailing Address - Country:US
Mailing Address - Phone:808-518-0007
Mailing Address - Fax:
Practice Address - Street 1:8226 DOUGLAS AVE STE 104
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-5906
Practice Address - Country:US
Practice Address - Phone:808-518-0007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-17
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI95646163W00000X
TX1114211363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse