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General NPI Number Information
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NPI Number | 1134911860
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Entity Type | Organization
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Legal Business Name | KANAB HEALTHCARE LLC
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Dates
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Enumeration Date | 05/19/2025
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 329 S 350 E STE 4
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City | KANAB
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State | UT
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Zip | 84741-3768
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Country | US
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Telephone | 435-899-0892
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Fax |
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Provider Business Mailing Address
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Address Line | 329 S 350 E STE 4
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City | KANAB
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State | UT
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Zip | 84741-3768
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Country | US
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Telephone | 435-644-5626
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | JILL GLAZIER BLASDELL
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Credential | FNP-C
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Telephone | 435-644-5626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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