Healthcare Provider Details

I. General information

NPI: 1588404941
Provider Name (Legal Business Name): TANGI PERRY BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2024
Last Update Date: 05/31/2024
Certification Date: 05/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 N MAIN ST STE 3
SPANISH FORK UT
84660-1763
US

IV. Provider business mailing address

903 S 770 E
SPANISH FORK UT
84660-2488
US

V. Phone/Fax

Practice location:
  • Phone: 385-985-3565
  • Fax:
Mailing address:
  • Phone: 801-592-2539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC2100X
TaxonomyContinence Care Registered Nurse
License Number278364-3102
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number278364-3102
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number278364-3102
License Number StateUT
# 4
Primary TaxonomyN
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number278364-3102
License Number StateUT
# 5
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number278364-3102
License Number StateUT
# 6
Primary TaxonomyN
Taxonomy Code163WU0100X
TaxonomyUrology Registered Nurse
License Number278364-3102
License Number StateUT
# 7
Primary TaxonomyY
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number278364-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: