Provider Demographics
NPI:1023280583
Name:STILES, ANGELA PACE (FNP)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:PACE
Last Name:STILES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 S. HIGHWAY 17
Mailing Address - Street 2:B
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576
Mailing Address - Country:US
Mailing Address - Phone:843-455-2528
Mailing Address - Fax:843-652-0172
Practice Address - Street 1:2115 S HIGHWAY 17
Practice Address - Street 2:UNIT B
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-7607
Practice Address - Country:US
Practice Address - Phone:843-455-2528
Practice Address - Fax:843-652-0172
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-25
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3491363LF0000X
NC5004057363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP1326Medicaid
SCNP1326Medicaid