MEDICARE: CATHERINE LEILANI BARRUS APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	7318347-4405	UT

General Provider Information

NPI Number	:	1891270062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE LEILANI BARRUS APRN

Provider Business Mailing Address
First Line	:	2833 INDIAN HILLS CIR
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84604-4333
Country	:	US
Telephone Number	:	801-915-9719
Fax Number	:

Provider Business Practice Location Address
First Line	:	2833 INDIAN HILLS CIR
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84604-4333
Country	:	US
Telephone Number	:	801-915-9719
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2018
Last Update Date	:	10/03/2018

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