Healthcare Provider Details

I. General information

NPI: 1376907055
Provider Name (Legal Business Name): ANGELA M. ZUGEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2016
Last Update Date: 04/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 OLIVE ST
SHERIDAN WY
82801-4938
US

IV. Provider business mailing address

850 OLIVE ST
SHERIDAN WY
82801-4938
US

V. Phone/Fax

Practice location:
  • Phone: 307-751-6261
  • Fax:
Mailing address:
  • Phone: 307-751-6261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: