Provider Demographics
NPI:1427752062
Name:GOEBEL, ANGELA MARIE (FNP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:GOEBEL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:LURAY
Mailing Address - State:VA
Mailing Address - Zip Code:22835-1000
Mailing Address - Country:US
Mailing Address - Phone:540-536-0103
Mailing Address - Fax:540-536-0235
Practice Address - Street 1:124 VALLEY VISTA DR
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:VA
Practice Address - Zip Code:22664-1608
Practice Address - Country:US
Practice Address - Phone:540-459-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-28
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024185974363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care