Provider Demographics
NPI:1982152393
Name:ST. ONGE, ANGELA SUE (AGPCNP-BC BSN-RN)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:SUE
Last Name:ST. ONGE
Suffix:
Gender:F
Credentials:AGPCNP-BC BSN-RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 CHANDLER DRIVE
Mailing Address - Street 2:ESSENTIA HEALTH SPOONER CLINIC
Mailing Address - City:SPOONER
Mailing Address - State:WI
Mailing Address - Zip Code:54801-2204
Mailing Address - Country:US
Mailing Address - Phone:715-635-2151
Mailing Address - Fax:715-635-8768
Practice Address - Street 1:1180 CHANDLER DR
Practice Address - Street 2:
Practice Address - City:SPOONER
Practice Address - State:WI
Practice Address - Zip Code:54801-2204
Practice Address - Country:US
Practice Address - Phone:715-635-2151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-14
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI156262-30163W00000X
WI7847-33363LP2300X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care