Provider Demographics
NPI:1992322465
Name:DUDLEY, ANGELA MONIQUE (DNP, ARNP, FNP-C)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:MONIQUE
Last Name:DUDLEY
Suffix:
Gender:F
Credentials:DNP, ARNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3412 CRESTMOOR PL
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-5011
Mailing Address - Country:US
Mailing Address - Phone:515-250-5575
Mailing Address - Fax:
Practice Address - Street 1:3412 CRESTMOOR PL
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-5011
Practice Address - Country:US
Practice Address - Phone:515-250-5575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA159436363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily