Healthcare Provider Details

I. General information

NPI: 1326003039
Provider Name (Legal Business Name): ANGELA ALLAN MAY FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANGELA ALLAN AMUNDSEN FNP-BC

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 05/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

668 N 44TH ST SUITE 391
PHOENIX AZ
85008-6506
US

IV. Provider business mailing address

668 N 44TH ST SUITE 391
PHOENIX AZ
85008-6506
US

V. Phone/Fax

Practice location:
  • Phone: 512-329-9223
  • Fax: 512-727-0544
Mailing address:
  • Phone: 512-329-9223
  • Fax: 512-727-0544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR56763
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP2994
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR069860
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: