Unknown Individual – Licensed Practical Nurse, NPI 1295995520
Licensed Practical Nurse
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
1141, 3900 South, Millcreek, Salt Lake County, Utah, 84124, United States
SUITE A-250
SALT LAKE CITY, UT 841241215
Phone: (801) 284-4904
Fax: (801) 284-4901
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84124)
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