Provider Demographics
NPI:1407396443
Name:CAPONE, ANGIE C (PMHNP)
Entity type:Individual
Prefix:MRS
First Name:ANGIE
Middle Name:C
Last Name:CAPONE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:MRS
Other - First Name:ANGIE
Other - Middle Name:C
Other - Last Name:KIM-CAPONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP
Mailing Address - Street 1:190 ROUTE 31
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-5773
Mailing Address - Country:US
Mailing Address - Phone:908-788-6654
Mailing Address - Fax:
Practice Address - Street 1:2100 WESCOTT DR
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-4603
Practice Address - Country:US
Practice Address - Phone:908-788-6654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-23
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00712400363LP0808X
VA0024186144363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health