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NPI Code Detail

MEDICARE: GILLIAN GENE TUFTS FNP

MEDICARE:   GILLIAN GENE TUFTS  FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner216178-4405UT

General Provider Information

NPI Number : 1083691737
Entity Type Code : Individual
Provider Name (Legal Business Name) : GILLIAN GENE TUFTS FNP
Provider Business Mailing Address
First Line : 2621 S 3270 W
Second Line :
City : WEST VALLEY CITY
State : UT
Zip : 84119-1119
Country : US
Telephone Number : 385-261-2737
Fax Number : 801-746-0420
Provider Business Practice Location Address
First Line : 1365 W 1000 N
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84116-1654
Country : US
Telephone Number : 801-328-5750
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2005
Last Update Date : 01/14/2020

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Directions to “ GILLIAN GENE TUFTS FNP” Practice Location

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