Provider Demographics
NPI:1740585603
Name:CHRISTNER, ANGELA LYNN (ARNP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:LYNN
Last Name:CHRISTNER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 W WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:IA
Mailing Address - Zip Code:50212-2046
Mailing Address - Country:US
Mailing Address - Phone:877-424-9321
Mailing Address - Fax:515-883-2692
Practice Address - Street 1:125 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:IA
Practice Address - Zip Code:50212-2046
Practice Address - Country:US
Practice Address - Phone:877-424-9321
Practice Address - Fax:515-275-2534
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-24
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-095302363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1740585603Medicaid