Provider Demographics
NPI:1114739661
Name:ECHEVERRY, ANGIE CAROLINA (NP)
Entity type:Individual
Prefix:
First Name:ANGIE
Middle Name:CAROLINA
Last Name:ECHEVERRY
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:RICHBORO
Mailing Address - State:PA
Mailing Address - Zip Code:18954-1838
Mailing Address - Country:US
Mailing Address - Phone:609-310-9389
Mailing Address - Fax:
Practice Address - Street 1:2 CAPITAL WAY STE 456
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-2521
Practice Address - Country:US
Practice Address - Phone:609-303-4838
Practice Address - Fax:609-303-4835
Is Sole Proprietor?:No
Enumeration Date:2025-01-22
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15230000363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care