Provider Demographics
NPI:1699357244
Name:MAYER, ANGELA (APRN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:MAYER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ANGIE
Other - Middle Name:
Other - Last Name:MAYER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:544 S 400 E
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-3705
Mailing Address - Country:US
Mailing Address - Phone:385-887-6000
Mailing Address - Fax:
Practice Address - Street 1:544 S 400 E
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-3705
Practice Address - Country:US
Practice Address - Phone:385-887-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-23
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10385497-3102163WM0705X
UT10385497-4405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical