Individual
ANGELLA M DITTBERNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3285 E SPARROW AVE, FLAGSTAFF, AZ 86004-7794
(928) 527-6163
Mailing address
1785 W SOFT WIND LN, FLAGSTAFF, AZ 86001-2824
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN171932
AZ
Other
Enumeration date
05/23/2012
Last updated
05/23/2012
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