Samuel Harry Van Rensburg
Nurse Practitioner - Gerontology Nurse Practitioner - Adult Health Nurse Practitioner - Primary Care and 1 more
440 S 500 E
Salt Lake City
, Utah 84102-2705
Samuel Harry Van Rensburg
Nurse Practitioner - Gerontology Nurse Practitioner - Adult Health Nurse Practitioner - Primary Care and 1 more
440 S 500 E
Salt Lake City
, Utah 84102-2705
(203) 343-9490
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About
Features
Specialties
- Nurse Practitioner - Adult Health
- Nurse Practitioner - Gerontology
- Nurse Practitioner - Primary Care
Languages spoken
- English
Location
First Address
- Samuel Harry Van Rensburg
- 1841 E Ramona Ave
- Salt Lake City, UT
- Zip : 84108-3111
- Phone : (203) 343-9490
Second Address
- Samuel Harry Van Rensburg
- 440 S 500 E
- Salt Lake City, UT
- Zip : 84102-2705
- Phone : (203) 343-9490
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What type of doctor is Samuel Harry Van Rensburg
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Is Samuel Harry Van Rensburg a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LA2200X | Nurse Practitioner - Adult Health | 11839389-4409 | UT |
| N | 363LA2200X | Nurse Practitioner - Adult Health | APRN02110 | RI |
| N | 363LG0600X | Nurse Practitioner - Gerontology | 11839389-4409 | UT |
| N | 363LG0600X | Nurse Practitioner - Gerontology | APRN02110 | RI |
| N | 363LP2300X | Nurse Practitioner - Primary Care | APRN02110 | RI |
National Provider Identifier
| NPI | 1063067346 |
|---|---|
| Provider Name | Samuel Harry Van Rensburg |
| First Address | Salt Lake City, UT 84108-3111 |
| Second Address | Salt Lake City, UT 84102-2705 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/08/2019 |
| Last Update Date | 30/09/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.