Healthcare Provider Details

I. General information

NPI: 1275010266
Provider Name (Legal Business Name): MONICA LINGARD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2018
Last Update Date: 07/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5121 S COTTONWOOD ST
MURRAY UT
84107-5701
US

IV. Provider business mailing address

57 S WALKER LN
NORTH SALT LAKE UT
84054-4117
US

V. Phone/Fax

Practice location:
  • Phone: 801-507-7673
  • Fax:
Mailing address:
  • Phone: 360-852-0156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number7328922-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: