Healthcare Provider Details

I. General information

NPI: 1619675725
Provider Name (Legal Business Name): ELIZABETH CLAIRE BLUEMEL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2023
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 N 1680 E STE E2
SAINT GEORGE UT
84790-2625
US

IV. Provider business mailing address

230 N 1680 E STE E2
SAINT GEORGE UT
84790-2625
US

V. Phone/Fax

Practice location:
  • Phone: 435-414-3049
  • Fax: 833-972-6044
Mailing address:
  • Phone: 435-414-3049
  • Fax: 833-972-6044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number8875685-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: