Provider Demographics
NPI:1043959729
Name:LEBOEUF, ANGELA M (RPH)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:LEBOEUF
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 AIRPORT HEIGHTS DR STE 195
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2982
Mailing Address - Country:US
Mailing Address - Phone:907-279-2425
Mailing Address - Fax:907-279-2426
Practice Address - Street 1:1200 AIRPORT HEIGHTS DR STE 195
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2982
Practice Address - Country:US
Practice Address - Phone:907-279-2425
Practice Address - Fax:907-279-2426
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1096183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist