Provider Demographics
NPI:1043799810
Name:MAKSUTOSKI, ANGELA (ARNP, FNP-C)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:MAKSUTOSKI
Suffix:
Gender:F
Credentials:ARNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 LAUREL ST STE A300
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314-3030
Mailing Address - Country:US
Mailing Address - Phone:515-282-2921
Mailing Address - Fax:
Practice Address - Street 1:411 LAUREL ST STE A300
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-3030
Practice Address - Country:US
Practice Address - Phone:515-282-2921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-12
Last Update Date:2022-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA121672363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily