Blackett, Angie Rena
Blackett, Angie Rena is an sole proprietor health care provider with primary practice located at 14443 S Chrome Rd , Herriman UT 84096-1204. She recently has only one registered license in Other Service Providers / Midwife, which is considered as her primary health care specialty. Blackett, Angie Rena can be contacted via phone (801) 200-1873.Contact Information
Primary practice address
14443 S Chrome Rd
Herriman UT 84096-1204
Phone: (801) 200-1873
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Midwife | 176B00000X |
Profile Details
| NPI number | 1033372081 |
|---|---|
| LBN Legal business name | Blackett, Angie Rena |
| Credentials | RN, CPM, LDEM |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 9th, 2008 |
| Last updated | Feb 4th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033372081 | NPPES |
| Utah | Other | 286486-3400 | STATE LICENSE |
| Utah | Other | 08100017 | STATE LICENSE |
| Utah | Other | 286486-3102 | STATE LICENSE |
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