Provider Demographics
NPI:1932485968
Name:FOX, ANGELA MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:FOX
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8230 VIKING BLVD NE
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MN
Mailing Address - Zip Code:55092-9436
Mailing Address - Country:US
Mailing Address - Phone:651-428-8967
Mailing Address - Fax:
Practice Address - Street 1:1075 HIGHWAY 96 E
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55127-2326
Practice Address - Country:US
Practice Address - Phone:651-426-9225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN118892183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist