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NPI Code Detail

MEDICARE: PATRICIA J DULLE M.S. APRN

MEDICARE: PATRICIA J DULLE M.S. APRN
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
1364SP0808XPsychiatric/Mental Health Clinical Nurse Specialist1856904405UT

General Provider Information

NPI Number : 1245292648
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA J DULLE M.S. APRN
Provider Business Mailing Address
First Line : 2285 WOODCHUCK WAY
Second Line :
City : SANDY
State : UT
Zip : 84093-2767
Country : US
Telephone Number : 801-944-0922
Fax Number :
Provider Business Practice Location Address
First Line : 660 S 200 E
Second Line : 308
City : SALT LAKE CITY
State : UT
Zip : 84111-3835
Country : US
Telephone Number : 801-355-2846
Fax Number : 801-359-3244
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2006
Last Update Date : 07/08/2007

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