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General NPI Number Information
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NPI Number | 1558428458
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Entity Type | Individual
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Provider Name | ANGELA D ST JOHN FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 01/02/2024
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Provider Practice Location Address
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Address Line | 729 NUCLEUS AVE STE A
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City | COLUMBIA FALLS
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State | MT
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Zip | 59912-4056
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Country | US
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Telephone | 406-890-8305
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Fax | 907-215-7963
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Provider Business Mailing Address
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Address Line | PO BOX 1364
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City | COLUMBIA FALLS
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State | MT
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Zip | 59912-1364
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Country | US
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Telephone | 406-890-8305
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Fax | 907-215-7963
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 19254
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 105094
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License Number State | MT
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