Provider Demographics
NPI:1144095886
Name:PIETRANGELO, MARIAH ARLENE (WHNP)
Entity type:Individual
Prefix:
First Name:MARIAH
Middle Name:ARLENE
Last Name:PIETRANGELO
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:MARIAH
Other - Middle Name:ARLENE
Other - Last Name:LADD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:217 RAINSHADOW CT
Mailing Address - Street 2:
Mailing Address - City:RIDGECREST
Mailing Address - State:CA
Mailing Address - Zip Code:93555-7576
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1011 N CHINA LAKE BLVD
Practice Address - Street 2:
Practice Address - City:RIDGECREST
Practice Address - State:CA
Practice Address - Zip Code:93555-3130
Practice Address - Country:US
Practice Address - Phone:760-499-3640
Practice Address - Fax:760-499-7229
Is Sole Proprietor?:No
Enumeration Date:2023-11-22
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95027581363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health