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General NPI Number Information
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NPI Number | 1629843081
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Entity Type | Individual
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Provider Name | ANGELINA MARSICO CRNP, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/16/2023
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Last Update Date | 11/16/2023
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Provider Practice Location Address
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Address Line | 7564 BROWNS MILL RD
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City | CHAMBERSBURG
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State | PA
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Zip | 17202-9252
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Country | US
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Telephone | 717-375-4834
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Fax |
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Provider Business Mailing Address
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Address Line | 11844 GUM TREE RD
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City | BROGUE
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State | PA
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Zip | 17309-9199
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | SP027959
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License Number State | PA
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