Individual
ANGALA DEE BRYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1262 FIR AVE, ROOSEVELT, UT 84066-3820
(801) 455-7492
Mailing address
1262 FIR AVE, ROOSEVELT, UT 84066-3820
(801) 455-7492
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
8026005-3102
UT
363L00000X
Nurse Practitioner
Primary
8026005-4405
UT
363L00000X
Nurse Practitioner
8026005-8900
UT
Other
Enumeration date
05/10/2021
Last updated
02/22/2022
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