Provider Demographics
NPI:1508500398
Name:MCLOUGHLIN, ANGELIQUE CAROLINE (APRN)
Entity type:Individual
Prefix:MRS
First Name:ANGELIQUE
Middle Name:CAROLINE
Last Name:MCLOUGHLIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 BOOTH RD STE D
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-5718
Mailing Address - Country:US
Mailing Address - Phone:407-906-3755
Mailing Address - Fax:386-271-2861
Practice Address - Street 1:208 BOOTH RD STE D
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-5718
Practice Address - Country:US
Practice Address - Phone:407-906-3755
Practice Address - Fax:386-271-2861
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-26
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11022271363LP0808X
FLRN9467528363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health