Provider Demographics
NPI:1073140836
Name:LUTHER, ANGELA MARION (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARION
Last Name:LUTHER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SHENANGO AVE
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-1503
Mailing Address - Country:US
Mailing Address - Phone:724-658-4585
Mailing Address - Fax:724-657-8563
Practice Address - Street 1:1112 S MILL ST
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-4629
Practice Address - Country:US
Practice Address - Phone:724-658-4564
Practice Address - Fax:724-657-8563
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP021666363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1037624100001Medicaid