Provider Demographics
NPI:1376202424
Name:ANGOOD, MARNI WILMA
Entity Type:Individual
Prefix:
First Name:MARNI
Middle Name:WILMA
Last Name:ANGOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 JOSEPHINE AVE
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-5696
Mailing Address - Country:US
Mailing Address - Phone:406-830-5449
Mailing Address - Fax:
Practice Address - Street 1:1715 JOSEPHINE AVE
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-5696
Practice Address - Country:US
Practice Address - Phone:406-830-5449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider