Provider Demographics
NPI:1750900379
Name:D'ANGELO, GEMMA NICOLE (CRNP)
Entity type:Individual
Prefix:MISS
First Name:GEMMA
Middle Name:NICOLE
Last Name:D'ANGELO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:996 STONEYBROOK DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-3829
Mailing Address - Country:US
Mailing Address - Phone:610-220-0531
Mailing Address - Fax:
Practice Address - Street 1:996 STONEYBROOK DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-3829
Practice Address - Country:US
Practice Address - Phone:610-220-0531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-14
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP021768363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner