Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Angel Brown Boulware, FNP-C

Individual provider Family Nurse Practitioner · NPI 1467704429

Angel Brown Boulware, FNP-C is a Nurse Practitioner in Lawrenceville, Georgia. Qualified in 2012, 14 years ago. Practices with Northside Cv Professional Services LLC, a 53-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
14
Licensed in
GA
In the registry since
2012
Specialties on file
2
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

2200 Medical Center Blvd Ste 400
Lawrenceville, GA 30046-7769
Phone: (678) 582-8586
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4288 Memorial Dr Ste B, Decatur, GA 30032-1229 — (770) 456-5701

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence RN172317 (GA)
Nurse Practitioner Taxonomy 363L00000X · Licence RN172317 (GA)

Record details

NPI number1467704429
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedOctober 15, 2012
Last updated in NPPESOctober 10, 2025
Certification dateOctober 10, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Northside Cv Professional Services Llc — 53 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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