Provider Demographics
NPI:1528309739
Name:PENA, ANGELA MICHELLE (APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MICHELLE
Last Name:PENA
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-1048
Mailing Address - Country:US
Mailing Address - Phone:866-389-2727
Mailing Address - Fax:512-310-8408
Practice Address - Street 1:501 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-1048
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:512-310-8408
Is Sole Proprietor?:No
Enumeration Date:2013-03-13
Last Update Date:2025-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX710258363L00000X
TXAP122809363LF0000X
MECNP191264363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX324078001Medicaid
TX295579YN56Medicare PIN
TX295579YN57Medicare PIN