=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811992928
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JANET K HARNSBERGER M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/15/2005
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5770 S 250 E STE 330
-----------------------------------------------------
City | MURRAY
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84107-8104
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-314-4444
-----------------------------------------------------
Fax | 801-314-4433
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5770 S 250 E STE 330
-----------------------------------------------------
City | MURRAY
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84107-8104
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-314-4444
-----------------------------------------------------
Fax | 801-314-4433
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2080P0206X
-----------------------------------------------------
Taxonomy Name | Pediatric Gastroenterology Physician
-----------------------------------------------------
License Number | 165969-1205
-----------------------------------------------------
License Number State | UT
-----------------------------------------------------