1861721086 NPI number — MRS. DONNA LUCILLE FERRELL APRN

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861721086 NPI number — MRS. DONNA LUCILLE FERRELL APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FERRELL
Provider First Name:
DONNA
Provider Middle Name:
LUCILLE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861721086
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/27/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5770 S 250 E STE 340
Provider Second Line Business Mailing Address:
INTERMOUNTAIN SLEEP DISORDERS
Provider Business Mailing Address City Name:
MURRAY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84107-8163
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-314-2400
Provider Business Mailing Address Fax Number:
801-314-2385

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5770 S 250 E STE 340
Provider Second Line Business Practice Location Address:
INTERMOUNTAIN SLEEP DISORDERS
Provider Business Practice Location Address City Name:
MURRAY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84107-8163
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-314-2400
Provider Business Practice Location Address Fax Number:
801-314-2385
Provider Enumeration Date:
12/17/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  374720-4405 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com