Provider Demographics
NPI:1992171185
Name:PAGE, ANGELA CURTIS (PNP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:CURTIS
Last Name:PAGE
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:484 E 1250 S
Mailing Address - Street 2:
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037-4005
Mailing Address - Country:US
Mailing Address - Phone:801-680-9371
Mailing Address - Fax:
Practice Address - Street 1:484 E 1250 S
Practice Address - Street 2:
Practice Address - City:KAYSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84037-4005
Practice Address - Country:US
Practice Address - Phone:801-680-9371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-11
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT212259-4405363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics