Individual
MRS. ANGELINA KELLY VISCARDI WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11960 LIONESS WAY STE 260, PARKER, CO 80134
(303) 344-9090
(720) 895-1121
Mailing address
8101 E LOWRY BLVD STE 230, DENVER, CO 80230-7195
(303) 344-9090
(303) 344-1922
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2178
CO
363AS0400X
Surgical Physician Assistant
2178
CO
Other
Enumeration date
08/19/2006
Last updated
06/06/2018
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