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NPI Code Detail

MEDICARE: RANAE POWER APRN

MEDICARE:   RANAE  POWER  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
1163W00000XRegistered Nurse354824-4405UT
2363LF0000XFamily Nurse Practitioner354824-4405UT

General Provider Information

NPI Number : 1770540783
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANAE POWER APRN
Provider Business Mailing Address
First Line : PO BOX 27128
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84127-0128
Country : US
Telephone Number : 801-491-6482
Fax Number :
Provider Business Practice Location Address
First Line : 1665 BONANZA DR.
Second Line :
City : PARK CITY
State : UT
Zip : 84060-5127
Country : US
Telephone Number : 801-491-6482
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2006
Last Update Date : 08/31/2012

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Directions to “ RANAE POWER APRN” Practice Location

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