Provider Demographics
NPI:1932831120
Name:SILKO, ANGELINA (DNP)
Entity Type:Individual
Prefix:
First Name:ANGELINA
Middle Name:
Last Name:SILKO
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15505 MINNESOTA VALLEY BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379-8228
Mailing Address - Country:US
Mailing Address - Phone:612-964-8751
Mailing Address - Fax:
Practice Address - Street 1:1010 6TH AVE W
Practice Address - Street 2:
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-2213
Practice Address - Country:US
Practice Address - Phone:612-255-0629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5053363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty