Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 314747-3102 | UT |
NPI | 1083037766 |
---|---|
Provider Name | Mrs. Lyn Standing |
First Address | Ogden, UT 84404-9742 |
Second Address | Slc, UT 84113-1103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2014 |
Last Update Date | 27/09/2016 |