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Organization
ANGELIC PRIMARY MEDICINE LLC
Active
Organization
ANGELIC PRIMARY MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANET GIBSON APN (OWNER/DIRECTOR)
(609) 515-4759
Entity
Organization
Contact information
Practice address
8025 BLACK HORSE PIKE STE 501, PLEASANTVILLE, NJ 08232-2967
(854) 600-9684
(609) 415-1875
Mailing address
PO BOX 313, LINWOOD, NJ 08221-0313
(854) 600-9684
(609) 415-1875
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
NULL
207QA0505X
Adult Medicine Physician
Primary
—
—
363LG0600X
Gerontology Nurse Practitioner
—
NULL
363LG0600X
Gerontology Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
NULL
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
11/25/2019
Last updated
10/01/2026
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