Provider Demographics
NPI:1154043610
Name:D'ANGELO, MAGGIE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:MAGGIE
Middle Name:
Last Name:D'ANGELO
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 WOODSAGE LN
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-4346
Mailing Address - Country:US
Mailing Address - Phone:919-606-4215
Mailing Address - Fax:
Practice Address - Street 1:160 NE MAYNARD RD STE 200
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-9671
Practice Address - Country:US
Practice Address - Phone:919-466-7540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2023-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4YP5D8MI163W00000X
NC5017664363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2022097187OtherBOARD CERTIFICATION NUMBER