Provider Demographics
NPI:1881948339
Name:GOOD, ANGELA J (FNP)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:J
Last Name:GOOD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:992 DURHAM RD STE C
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-6590
Mailing Address - Country:US
Mailing Address - Phone:919-263-0827
Mailing Address - Fax:999-586-3233
Practice Address - Street 1:992 DURHAM RD STE C
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-6590
Practice Address - Country:US
Practice Address - Phone:919-263-0827
Practice Address - Fax:888-586-3233
Is Sole Proprietor?:No
Enumeration Date:2012-11-06
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5005895363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1881948339Medicaid