Provider Demographics
NPI:1780221523
Name:MANTHEI, ANGELA MURRAY (PA-C)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MURRAY
Last Name:MANTHEI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7195 ADVANCED WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-3691
Mailing Address - Country:US
Mailing Address - Phone:702-740-5327
Mailing Address - Fax:
Practice Address - Street 1:7195 ADVANCED WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-3691
Practice Address - Country:US
Practice Address - Phone:702-740-5327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-27
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty