Healthcare Provider Details

I. General information

NPI: 1194650325
Provider Name (Legal Business Name): LILLIAN NUNES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 N 500 W STE C
LEHI UT
84043-1771
US

IV. Provider business mailing address

90 N 500 W STE C
LEHI UT
84043-1771
US

V. Phone/Fax

Practice location:
  • Phone: 801-449-0281
  • Fax: 385-483-4376
Mailing address:
  • Phone: 801-449-0281
  • Fax: 385-483-4376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: