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General NPI Number Information
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NPI Number | 1982152393
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Entity Type | Individual
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Provider Name | ANGELA SUE ST. ONGE AGPCNP-BC. BSN-RN
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Gender | Female
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Dates
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Enumeration Date | 09/14/2016
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1180 CHANDLER DR
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City | SPOONER
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State | WI
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Zip | 54801-2204
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Country | US
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Telephone | 715-635-2151
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Fax |
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Provider Business Mailing Address
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Address Line | 1180 CHANDLER DRIVE ESSENTIA HEALTH SPOONER CLINIC
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City | SPOONER
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State | WI
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Zip | 54801-2204
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Country | US
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Telephone | 715-635-2151
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Fax | 715-635-8768
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 156262-30
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 7847-33
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 7847-33
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License Number State | WI
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