Provider Demographics
NPI:1326003039
Name:MAY, ANGELA ALLAN (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:ALLAN
Last Name:MAY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:ALLAN
Other - Last Name:AMUNDSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:668 N 44TH ST
Mailing Address - Street 2:SUITE 391
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-6506
Mailing Address - Country:US
Mailing Address - Phone:512-329-9223
Mailing Address - Fax:512-727-0544
Practice Address - Street 1:668 N 44TH ST
Practice Address - Street 2:SUITE 391
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-6506
Practice Address - Country:US
Practice Address - Phone:512-329-9223
Practice Address - Fax:512-727-0544
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR56763163W00000X
AZAP2994363L00000X
AZR069860163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM90102771Medicaid
Q70333Medicare UPIN
NM347622301Medicare PIN