Provider Demographics
NPI:1720810203
Name:GATES DAQUILA, ANGELA KATHERINE (BSN, RN)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:KATHERINE
Last Name:GATES DAQUILA
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 PEACHTREE RD NW
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27896-2056
Mailing Address - Country:US
Mailing Address - Phone:407-462-1234
Mailing Address - Fax:
Practice Address - Street 1:1109 PEACHTREE RD NW
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27896-2056
Practice Address - Country:US
Practice Address - Phone:407-462-1234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-14
Last Update Date:2025-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC379568163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse