Individual
MRS. ANGELA MARIE NICHOLSON KRULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10011 CENTENNIAL PKWY, SUITE 500, SANDY, UT 84070-4156
(801) 676-7627
(801) 676-7630
Mailing address
10011 CENTENNIAL PKWY, SUITE 500, SANDY, UT 84070-4156
(801) 676-7627
(801) 676-7630
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
61429451205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316160534
GROUP NPI
UT
Enumeration date
09/20/2006
Last updated
03/05/2008
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