Provider Demographics
NPI:1821883927
Name:TAPIA, ANGELA MARIE (LPN)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:TAPIA
Suffix:
Gender:
Credentials:LPN
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:MARIE
Other - Last Name:BLAKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:2142 E 50 SOUTH CIR
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-1579
Mailing Address - Country:US
Mailing Address - Phone:951-642-5504
Mailing Address - Fax:
Practice Address - Street 1:3611 S CAMINO REAL
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:UT
Practice Address - Zip Code:84780-8396
Practice Address - Country:US
Practice Address - Phone:435-627-5197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14176547-3101164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse