Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 8699646-1205 | UT |
N | 207Q00000X | Family Doctor | MD-18253 | HI |
NPI | 1003176652 |
---|---|
Provider Name | Janee Namealoha Sells |
First Address | Provo, UT 84606-6138 |
Second Address | Provo, UT 84604-4682 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2012 |
Last Update Date | 10/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
791831 | (05) | HI |