# ANGELIC PRIMARY MEDICINE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477199446
- **Authorized official:** MRS. JANET GIBSON APN (OWNER/DIRECTOR)
- **Authorized official phone:** (609) 515-4759

## Contact information

- **Practice address:** 8025 BLACK HORSE PIKE STE 501, PLEASANTVILLE, NJ 08232-2967
- **Practice address phone:** (854) 600-9684
- **Practice address fax:** (609) 415-1875
- **Mailing address:** PO BOX 313, LINWOOD, NJ 08221-0313
- **Mailing address phone:** (854) 600-9684
- **Mailing address fax:** (609) 415-1875

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |
| 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