Provider Demographics
NPI:1669720041
Name:FELTON-WILKS, ANGELIA L (APNP, FNPC, PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:ANGELIA
Middle Name:L
Last Name:FELTON-WILKS
Suffix:
Gender:F
Credentials:APNP, FNPC, PMHNP-BC
Other - Prefix:MRS
Other - First Name:ANGELIA
Other - Middle Name:L
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN, MSN, APNP
Mailing Address - Street 1:7235 W APPLETON AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-1932
Mailing Address - Country:US
Mailing Address - Phone:414-312-8683
Mailing Address - Fax:414-488-8152
Practice Address - Street 1:7235 W APPLETON AVE STE 2
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-1932
Practice Address - Country:US
Practice Address - Phone:414-312-8683
Practice Address - Fax:414-488-8152
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI669733363LF0000X, 363LP0808X
WI6697-33363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1669720041Medicaid
WI1669720041Medicaid