Individual
ANGELA LOUISE WADSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
514 N BRIGHTLEAF BLVD STE 1620, SMITHFIELD, NC 27577-4486
(919) 938-7187
(919) 938-7201
Mailing address
514 N BRIGHTLEAF BLVD STE 1620, SMITHFIELD, NC 27577-4486
(919) 938-7187
(919) 938-0296
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5005012
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003118084
—
NC
01
—
1751V
BCBSNC
NC
01
—
2595135
MEDICARE
NC
Enumeration date
11/24/2010
Last updated
03/31/2021
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