Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 593144 | TX |
N | 111NI0900X | Internist | 593144 | TX |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 12240891-1204 | UT |
NPI | 1104287747 |
---|---|
Provider Name | Dr. Linnea W. Lebaron |
First Address | Salt Lake City, UT 84132-0002 |
Second Address | Salt Lake City, UT 84132-0002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2016 |
Last Update Date | 20/05/2021 |