Provider Demographics
NPI:1528790276
Name:SMUGALA, ANNA JANE (APNP)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:JANE
Last Name:SMUGALA
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:JANE
Other - Last Name:LINDBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:203 COUNTRY CLUB LN
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:WI
Mailing Address - Zip Code:54720-1009
Mailing Address - Country:US
Mailing Address - Phone:763-258-4420
Mailing Address - Fax:
Practice Address - Street 1:2200 CRAIG RD
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-2699
Practice Address - Country:US
Practice Address - Phone:715-858-6767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-29
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WI13121-33363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner