Healthcare Provider Details

I. General information

NPI: 1750896643
Provider Name (Legal Business Name): LYNDEN BAYLIE SCHELLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LYNDEN BAYLIE TURNER

II. Dates (important events)

Enumeration Date: 12/13/2017
Last Update Date: 12/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

857 E 200 S
SALT LAKE CITY UT
84102-2317
US

IV. Provider business mailing address

857 E 200 S
SALT LAKE CITY UT
84102-2317
US

V. Phone/Fax

Practice location:
  • Phone: 801-487-3276
  • Fax: 801-487-3276
Mailing address:
  • Phone: 801-487-3276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: