Unknown Individual – Registered Nurse, NPI 1003906108

Unknown Individual is a healthcare provider. based in Logan, Utah. specializing in Registered Nurse. They hold a License No. 5143831-3102 (UT). The NPI Number for Unknown Individual is 1003906108

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1003906108
Phone
(435) 752-0750
Address
90 E 200 N
Deactivation Date
1 November 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 90, East 200 North, Logan, Cache County, Utah, 84321, United States

    LOGAN, UT 843214034

    Phone: (435) 752-0750

    Type: Location

  • 11, Shadow Mountain Drive, Logan, Cache County, Utah, 84321, United States

    LOGAN, UT 843216737

    Phone: (435) 753-7767

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84321)

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Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1003906108 if you need a stable reference for Unknown Individual.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What kind of provider is Unknown Individual?
The page reflects Registered Nurse for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Logan, Utah for Unknown Individual; download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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