Provider Demographics
NPI:1801500087
Name:RAAB, ANGELA B (CRNP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:B
Last Name:RAAB
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 1:1810 OXFORD SQ
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-2573
Mailing Address - Country:US
Mailing Address - Phone:410-983-1088
Mailing Address - Fax:
Practice Address - Street 1:2014 S TOLLGATE RD
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-5903
Practice Address - Country:US
Practice Address - Phone:410-670-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-11
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR218558363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily