Mary Angela Clouse, FNP-BC
Nurse Practitioner, Family in Gilbert, AZ. Individual provider (NPI-1).
NPI number1982128351
StatusActive
Last updated in NPPESJul 11, 2023
Details
- NPI
- 1982128351
- Entity type
- Individual (NPI-1)
- Name
- Mary Angela Clouse
- Credential
- FNP-BC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 27, 2017
- Certification date
- Jul 11, 2023
- Last updated
- Jul 11, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | AP10428 | AZ | Yes |
| 363LF0000X | Nurse Practitioner, Family | AP61372083 | WA | |
| 363LF0000X | Nurse Practitioner, Family | C-APN.0004738-C-NP | CO | |
| 363LF0000X | Nurse Practitioner, Family | 13396889-4405 | UT |
Practice location
1922 E Linda LnGilbert, AZ 85234-6112
Phone 480-290-3509
Mailing address
1922 E Linda LnGilbert, AZ 85234-6112
Phone 480-290-3509
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