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General NPI Number Information
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NPI Number | 1093649857
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Entity Type | Individual
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Provider Name | CARLOS ARIEL TITA RN, CDCES
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Gender | Male
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Dates
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Enumeration Date | 06/09/2026
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Last Update Date | 06/09/2026
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Provider Practice Location Address
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Address Line | 589 S STATE ST
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City | PROVO
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State | UT
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Zip | 84606-5056
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Country | US
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Telephone | 801-429-2000
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Fax | 801-429-2001
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Provider Business Mailing Address
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Address Line | 1778 W 950 S
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City | SPRINGVILLE
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State | UT
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Zip | 84663-3544
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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License Number | 11290048-3102
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 163WW0101X
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Taxonomy Name | Ambulatory Women's Health Care Registered Nurse
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License Number | 11290048-3102
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | 11290048-3102
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License Number State | UT
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