Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 4869823-4405 | UT |
NPI | 1235529959 |
---|---|
Provider Name | Angela Kay Ashcroft |
First Address | Smithfield, UT 84335-6744 |
Second Address | Ogden, UT 84403-3195 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2015 |
Last Update Date | 06/09/2021 |