Provider Demographics
NPI:1710379706
Name:LOUQUE, ANGELA LOUALAN (FNP-C)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:LOUALAN
Last Name:LOUQUE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:ANGELA
Other - Middle Name:LOUALAN
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:11770 US HIGHWAY 1 STE 102E
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33408-3052
Mailing Address - Country:US
Mailing Address - Phone:561-815-2427
Mailing Address - Fax:
Practice Address - Street 1:6700 NW 10TH PL
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4213
Practice Address - Country:US
Practice Address - Phone:352-331-3111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-27
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9414513363LF0000X, 363LF0000X
AZRN134287163WM0705X
FLARNP9414513363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016687100Medicaid
FL016687100Medicaid