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NPI Code Detail

MEDICARE: ANGELICA ROTHERMEL RN, BSN, CCRN

MEDICARE: ANGELICA ROTHERMEL RN, BSN, CCRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse325359NC

General Provider Information

NPI Number : 1558220962
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELICA ROTHERMEL RN, BSN, CCRN
Provider Business Mailing Address
First Line : 4408 CORNELL AVE
Second Line :
City : GREENSBORO
State : NC
Zip : 27407-1704
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1 MEDICAL CENTER BLVD
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27157-0001
Country : US
Telephone Number : 336-716-6011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2026
Last Update Date : 01/21/2026

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