Provider Demographics
NPI:1275620882
Name:WHITNEY, ANGELA (RPH)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:
Last Name:WHITNEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12091 KATELYN PARK CT
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-8332
Mailing Address - Country:US
Mailing Address - Phone:801-816-1497
Mailing Address - Fax:
Practice Address - Street 1:36 S STATE ST
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-1401
Practice Address - Country:US
Practice Address - Phone:801-442-3244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT131503-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist