Provider Demographics
NPI:1851098123
Name:JENNINGS, ANGELA NICOLE (DNP)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:NICOLE
Last Name:JENNINGS
Suffix:
Gender:
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4015 BOW CT
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-9497
Mailing Address - Country:US
Mailing Address - Phone:434-429-6235
Mailing Address - Fax:336-859-6326
Practice Address - Street 1:3407 W WENDOVER AVE STE D
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-1584
Practice Address - Country:US
Practice Address - Phone:336-589-1223
Practice Address - Fax:888-815-0892
Is Sole Proprietor?:No
Enumeration Date:2023-02-07
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC296818163W00000X
NCAG06230007363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse