Provider Demographics
NPI:1144656133
Name:GARCIA, ANGELA (NP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:SOUAD
Other - Last Name:SHAHEEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, NP
Mailing Address - Street 1:4445 CORPORATION LN STE 100
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3666
Mailing Address - Country:US
Mailing Address - Phone:757-623-0005
Mailing Address - Fax:757-589-1129
Practice Address - Street 1:1200 FIRST COLONIAL RD
Practice Address - Street 2:SUITE 202
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-2207
Practice Address - Country:US
Practice Address - Phone:757-623-0005
Practice Address - Fax:757-389-5383
Is Sole Proprietor?:No
Enumeration Date:2013-09-23
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001197487363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily