Healthcare Provider Details

I. General information

NPI: 1265119424
Provider Name (Legal Business Name): ANGELE LAPORTE-FERDINAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2023
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 ST LUKES LN
STROUDSBURG PA
18360-6217
US

IV. Provider business mailing address

100 ST LUKES LN
STROUDSBURG PA
18360-6217
US

V. Phone/Fax

Practice location:
  • Phone: 272-212-0204
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NR15456500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP027784
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: