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General NPI Number Information
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NPI Number | 1568538841
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Entity Type | Individual
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Provider Name | LISA DORIUS RN
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Gender | Female
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 151 S UNIVERSITY AVE # 1900
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City | PROVO
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State | UT
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Zip | 84601-4427
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Country | US
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Telephone | 801-851-7047
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Fax | 801-785-6682
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Provider Business Mailing Address
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Address Line | 10154 N COTTONWOOD DR
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City | CEDAR HILLS
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State | UT
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Zip | 84062-9231
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Country | US
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Telephone | 801-785-5363
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Fax | 801-785-6682
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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 | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 197042-3102
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License Number State | UT
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