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General NPI Number Information
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NPI Number | 1851098123
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Entity Type | Individual
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Provider Name | ANGELA NICOLE JENNINGS DNP
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Gender | Female
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Dates
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Enumeration Date | 02/07/2023
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 3407 W WENDOVER AVE STE D
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City | GREENSBORO
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State | NC
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Zip | 27407-1584
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Country | US
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Telephone | 336-589-1223
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Fax | 888-815-0892
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Provider Business Mailing Address
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Address Line | 4015 BOW CT
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City | BURLINGTON
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State | NC
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Zip | 27215-9497
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Country | US
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Telephone | 434-429-6235
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Fax | 336-859-6326
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 296818
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AG06230007
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License Number State | NC
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