Healthcare Provider Details

I. General information

NPI: 1265034623
Provider Name (Legal Business Name): ANGELICA NICOLINA FERRAZZI PETROUS DNP, APRN, AGPCNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANGELICA NICOLINA FERRAZZI DNP, APRN, AGPCNP-BC

II. Dates (important events)

Enumeration Date: 11/11/2020
Last Update Date: 03/16/2025
Certification Date: 03/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7503 SURRATTS RD STE 101
CLINTON MD
20735-3358
US

IV. Provider business mailing address

7503 SURRATTS RD
CLINTON MD
20735-3358
US

V. Phone/Fax

Practice location:
  • Phone: 301-877-4673
  • Fax: 301-235-3381
Mailing address:
  • Phone: 301-877-4673
  • Fax: 301-235-3381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN1030205
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberRN1030205
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberRN1030205
License Number StateDC
# 4
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAC003509
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: