=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700288727
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DEBRA LEDINGHAM WHNP, CNM
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/22/2014
-----------------------------------------------------
Last Update Date | 09/28/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 505 W 400 N
-----------------------------------------------------
City | OREM
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84057-1950
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-714-3422
-----------------------------------------------------
Fax | 871-434-2401
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 505 W 400 N
-----------------------------------------------------
City | OREM
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84057-1950
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-714-3422
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LW0102X
-----------------------------------------------------
Taxonomy Name | Women's Health Nurse Practitioner
-----------------------------------------------------
License Number | 190459-4405
-----------------------------------------------------
License Number State | UT
-----------------------------------------------------