Provider Demographics
NPI:1447943253
Name:RICH, ANGLIQUE MARIE (PMHNP)
Entity type:Individual
Prefix:
First Name:ANGLIQUE
Middle Name:MARIE
Last Name:RICH
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 ADLEY WAY
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-6511
Mailing Address - Country:US
Mailing Address - Phone:864-987-9747
Mailing Address - Fax:864-987-9770
Practice Address - Street 1:225 ADLEY WAY
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-6511
Practice Address - Country:US
Practice Address - Phone:864-987-9747
Practice Address - Fax:864-987-9770
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC27500363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health