Healthcare Provider Details

I. General information

NPI: 1003773003
Provider Name (Legal Business Name): SINDI LORENA VIRGIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3314 E SOUTH RIDGE RD APT G9
EAGLE MOUNTAIN UT
84005-4735
US

IV. Provider business mailing address

3314 E SOUTH RIDGE RD APT G9
EAGLE MOUNTAIN UT
84005-4735
US

V. Phone/Fax

Practice location:
  • Phone: 385-250-8294
  • Fax:
Mailing address:
  • Phone: 385-250-8294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: