MEDICARE: JANIS MAAG NP

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	363L00000X	Nurse Practitioner	5151861-4405	UT

General Provider Information

NPI Number	:	1982112587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANIS MAAG NP

Provider Business Mailing Address
First Line	:	544 E 1200 S
Second Line	:
City	:	HEBER CITY
State	:	UT
Zip	:	84032-4497
Country	:	US
Telephone Number	:	801-397-4900
Fax Number	:

Provider Business Practice Location Address
First Line	:	544 E 1200 S
Second Line	:
City	:	HEBER CITY
State	:	UT
Zip	:	84032-4497
Country	:	US
Telephone Number	:	435-749-1818
Fax Number	:

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

Provider Enumeration Date	:	01/17/2018
Last Update Date	:	09/29/2021

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