Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 342206-1205 | UT |
NPI | 1699869479 |
---|---|
Provider Name | Jane Ellen Macpherson |
First Address | Salt Lake City, UT 84124-1297 |
Second Address | Murray, UT 84107-5701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 01/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E85084 | (02) | UT |
P00457716 | RAILROAD MEDICARE (01) | UT |