Healthcare Provider Details

I. General information

NPI: 1922641448
Provider Name (Legal Business Name): LILIAN SILVA DANA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2019
Last Update Date: 06/13/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 N 500 W SUITE. 222, BLDG. C
PROVO UT
84604
US

IV. Provider business mailing address

1055 N 500 W ATTN. CREDENTIALING
PROVO UT
84604
US

V. Phone/Fax

Practice location:
  • Phone: 801-812-5033
  • Fax: 801-812-5034
Mailing address:
  • Phone: 801-354-8225
  • Fax: 801-418-0941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number7680304-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: