Individual
ANGELA AFTON GRANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1525 W 2100 S, SALT LAKE CITY, UT 84119
(801) 213-9900
Mailing address
1525 W 2100 S, SALT LAKE CITY, UT 84119-1407
(801) 213-9900
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
8656828-4405
UT
363LF0000X
Family Nurse Practitioner
Primary
8656828-4405
UT
Other
Enumeration date
07/23/2019
Last updated
12/14/2021
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