Healthcare Provider Details

I. General information

NPI: 1023930138
Provider Name (Legal Business Name): ANGELA SITLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA CARMEN BURGESS

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 N FERRY ST
ANOKA MN
55303-1650
US

IV. Provider business mailing address

5453 HEATH AVE N
OAKDALE MN
55128-3052
US

V. Phone/Fax

Practice location:
  • Phone: 763-506-1000
  • Fax:
Mailing address:
  • Phone: 408-642-4275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: