Individual provider · NPI-1

Angela T Vandusen

Nurse Practitioner, Pediatrics · Daytona Beach, FL

NPI number1790653418
StatusActive
Last updated in NPPESOct 24, 2025

Details

NPI
1790653418
Entity type
Individual (NPI-1)
Name
Angela T Vandusen
Sex
Female
Sole proprietor
No
Enumeration date
Oct 24, 2025
Certification date
Oct 24, 2025
Last updated
Oct 24, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0200X Nurse Practitioner, Pediatrics11042915FLYes

Practice location

303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709

Phone 386-425-5000

Mailing address

303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709

Phone 386-425-5000

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Nurse Practitioner, Pediatrics providers in Daytona Beach, FL