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NPI Code Detail

MEDICARE: ANA M. DALLING PA

MEDICARE: ANA M. DALLING PA
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
1363A00000XPhysician Assistant4736097-1206UT

General Provider Information

NPI Number : 1699731067
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANA M. DALLING PA
Provider Business Mailing Address
First Line : 1912 W 930 N
Second Line :
City : PLEASANT GROVE
State : UT
Zip : 84062-4104
Country : US
Telephone Number : 801-492-1999
Fax Number : 801-492-1991
Provider Business Practice Location Address
First Line : 1912 W 930 N
Second Line :
City : PLEASANT GROVE
State : UT
Zip : 84062-4104
Country : US
Telephone Number : 801-492-1999
Fax Number : 801-492-1991
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2006
Last Update Date : 03/13/2012

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