| Doctor Name: | MS. ANGELA DAWN PETRY |
| NPI Number: | 1023286010 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P.-C |
| License Number: | 62864 |
| Business Practice Address: | 171 Taylor St Harpers Ferry, WV - 254253641 |
| Business Phone Number: | 3045356343 |
| Business Fax Number: | 3045356618 |
| Mailing Address: | 2500 Foundation Way, MARTINSBURG |
| State: | WV |
| Postal Code: | 254019000 |
| Phone Number: | 3042649202 |
| Fax Number: | 3042649042 |
| NPI Enumeration Date: | 02/13/2008 |
| NPI Last Update Date: | 12/22/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 62864 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |