Healthcare Provider Details

I. General information

NPI: 1861677825
Provider Name (Legal Business Name): APOLONIA G. SILVA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2008
Last Update Date: 06/03/2024
Certification Date: 04/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1776 PARK AVE STE 211
PARK CITY UT
84060-5148
US

IV. Provider business mailing address

1776 PARK AVE STE 211
PARK CITY UT
84060-5148
US

V. Phone/Fax

Practice location:
  • Phone: 385-464-3980
  • Fax: 385-464-3990
Mailing address:
  • Phone: 385-464-3980
  • Fax: 385-464-3990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number200850094NP
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number200850094NP
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberRN-00159301
License Number StateWA
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9835479-8900
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: