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General NPI Number Information
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NPI Number | 1740211622
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Entity Type | Individual
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Provider Name | ANGELA K. STORLIE PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 01/05/2015
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Provider Practice Location Address
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Address Line | 6405 FRANCE AVE S SUITE W440
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City | EDINA
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State | MN
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Zip | 55435-2163
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Country | US
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Telephone | 952-927-7004
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Fax | 952-927-5146
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Provider Business Mailing Address
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Address Line | 4570 W 77TH ST SUITE 235
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City | EDINA
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State | MN
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Zip | 55435-5008
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Country | US
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Telephone | 952-832-0805
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Fax | 952-832-5597
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 9603
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License Number State | MN
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