Provider Demographics
NPI:1760463988
Name:HOWDESHELL, ANGELA IMPERIAL (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:IMPERIAL
Last Name:HOWDESHELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:ENRIQUE
Other - Last Name:IMPERIAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1005
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82003-1005
Mailing Address - Country:US
Mailing Address - Phone:307-634-9653
Mailing Address - Fax:307-638-8256
Practice Address - Street 1:1263 N 15TH ST
Practice Address - Street 2:PEAK WELLNESS CENTER- ALBANY BRANCH
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82072-2343
Practice Address - Country:US
Practice Address - Phone:307-745-8915
Practice Address - Fax:307-745-8761
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYWY2103A2084P0800X
SD07982084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY305054OtherBS
A72914Medicare UPIN
WY305054Medicare ID - Type Unspecified