Individual
ANGELA MARIE BANZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4403 HARRISON BLVD STE 4650, OGDEN, UT 84403-3294
(801) 475-3240
Mailing address
PO BOX 5546, DENVER, CO 80217-5546
(801) 475-3500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10455364-1206
UT
363AM0700X
Medical Physician Assistant
10455364-1206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285151662
—
UT
Enumeration date
08/25/2017
Last updated
02/16/2026
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