Provider Demographics
NPI:1780795450
Name:ABDI, ANGELA MARIE (MSN,FNP,BC)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:MARIE
Last Name:ABDI
Suffix:
Gender:F
Credentials:MSN,FNP,BC
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:SURFACE
Other - Last Name:ABDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN,FNP,BC
Mailing Address - Street 1:2620 ELM HILL PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-3108
Mailing Address - Country:US
Mailing Address - Phone:187-785-2267
Mailing Address - Fax:615-425-4201
Practice Address - Street 1:2620 ELM HILL PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-3108
Practice Address - Country:US
Practice Address - Phone:187-785-2267
Practice Address - Fax:615-425-4201
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000104084363LF0000X
TNAPN7149363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VARN0001128527OtherLICENSE NUMBER RN
VA7781792Medicaid
TN103I502213OtherMEDICARE PTAN
TN000000118475Medicaid
TN1522336Medicaid
VANP0024128527OtherNURSE PRACTITIONER LICENS
TNAPN0000007149OtherADVANCED PRACTICE NUMBER
TN3346493Medicare ID - Type Unspecified
TN000000118475Medicaid