Healthcare Provider Details

I. General information

NPI: 1205772399
Provider Name (Legal Business Name): ZANE STILLMAN LEWIS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 E 1200 S
HEBER CITY UT
84032-4923
US

IV. Provider business mailing address

392 N 800 E
AMERICAN FORK UT
84003-1918
US

V. Phone/Fax

Practice location:
  • Phone: 775-397-1538
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number2021035472
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: