Provider Demographics
NPI:1609861749
Name:ATZEN, ANGELIA RENEE (DO)
Entity Type:Individual
Prefix:DR
First Name:ANGELIA
Middle Name:RENEE
Last Name:ATZEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7147 VISTA DR STE 150
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-9313
Mailing Address - Country:US
Mailing Address - Phone:515-875-9925
Mailing Address - Fax:515-875-9923
Practice Address - Street 1:160 ADVENTURELAND DR NW
Practice Address - Street 2:STE C
Practice Address - City:ALTOONA
Practice Address - State:IA
Practice Address - Zip Code:50009
Practice Address - Country:US
Practice Address - Phone:515-875-9020
Practice Address - Fax:515-875-9021
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADO-03475207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAH98745Medicare UPIN