Undercover Angels Mobile Phlebotomy LLC

Primary specialty

Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X

Legal business name

UNDERCOVER ANGELS MOBILE PHLEBOTOMY LLC

Practice address

17827 18TH Avenue CT E
Spanaway, WA 98387-4119

Phone

(253) 273-0571

NPI assigned

Jul 29, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kaneetah Velma Pridgen, PC 60845589NPI 1285202705

Title

Owner

Phone

(253) 273-0571

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kaneetah Velma Pridgen, MA-P

  • Phlebotomy Technician
  • Spanaway, WA
  • NPI 1285202705
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627516800000",
    "number": "1730852393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17827 18TH AVENUE CT E",
            "city": "SPANAWAY",
            "state": "WA",
            "postal_code": "983874119",
            "telephone_number": "253-273-0571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17827 18TH AVENUE CT E",
            "city": "SPANAWAY",
            "state": "WA",
            "postal_code": "983874119",
            "telephone_number": "253-273-0571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNDERCOVER ANGELS MOBILE PHLEBOTOMY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A",
        "authorized_official_last_name": "PRIDGEN",
        "authorized_official_first_name": "KANEETAH",
        "authorized_official_middle_name": "VELMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-273-0571",
        "authorized_official_credential": "PC 60845589"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah May Tramm
• Marie Antoinette Tsurgeon, PA-C
• Debbie K Turner, ARNP
• Sarah Turner, MA, LMHC
• Carina Ulrich
• Victoria Van Dusen
• Torri Veloz
• Alexia Villarreal
• Jennifer Ashley Vincent
• Rebecca Visintin

• Clinical Pathology/Laboratory Medicine Physician in Spanaway, WA
• Providers in Spanaway, WA by specialty
• Clinical Pathology/Laboratory Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.