Provider Demographics
NPI:1841522505
Name:DAMORE, ANGELA M (BN, RN, MSN, FNP-C)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:M
Last Name:DAMORE
Suffix:
Gender:F
Credentials:BN, RN, MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 W CRESCENT PARK
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:PA
Mailing Address - Zip Code:16365-2111
Mailing Address - Country:US
Mailing Address - Phone:814-723-0407
Mailing Address - Fax:814-726-9412
Practice Address - Street 1:2 W CRESCENT PARK FL 2
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:PA
Practice Address - Zip Code:16365-2111
Practice Address - Country:US
Practice Address - Phone:814-723-0407
Practice Address - Fax:814-726-9412
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-05
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY582468163WC1500X
NYF341177-1363LF0000X
PASP016927363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Multi-Specialty