Provider Demographics
NPI:1801553243
Name:ANGELA DAVIS, RN, MSN, PMHNP-BC
Entity type:Organization
Organization Name:ANGELA DAVIS, RN, MSN, PMHNP-BC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:856-304-1400
Mailing Address - Street 1:208 WHITE HORSE PIKE STE 8
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08007-1322
Mailing Address - Country:US
Mailing Address - Phone:856-304-1400
Mailing Address - Fax:
Practice Address - Street 1:10 SUNFLOWER CIR
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NJ
Practice Address - Zip Code:08048-4862
Practice Address - Country:US
Practice Address - Phone:856-304-1400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty