Provider Demographics
NPI:1700411451
Name:STOUT-PADOVANI, ANGEL (RPA)
Entity Type:Individual
Prefix:MRS
First Name:ANGEL
Middle Name:
Last Name:STOUT-PADOVANI
Suffix:
Gender:F
Credentials:RPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 DENVER WEST DR STE 101
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3172
Mailing Address - Country:US
Mailing Address - Phone:303-416-1360
Mailing Address - Fax:720-501-5199
Practice Address - Street 1:1819 DENVER WEST DR STE 101
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80401-3172
Practice Address - Country:US
Practice Address - Phone:303-854-9888
Practice Address - Fax:720-501-5199
Is Sole Proprietor?:No
Enumeration Date:2020-03-03
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT09M01394243U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes243U00000XTechnologists, Technicians & Other Technical Service ProvidersRadiology Practitioner Assistant