MEDICARE: APOLONIA G. SILVA 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
1	207RN0300X	Nephrology Physician	200850094NP	OR
2	363LF0000X	Family Nurse Practitioner	200850094NP	OR
3	390200000X	Student in an Organized Health Care Education/Training Program	RN-00159301	WA
4	363LF0000X	Family Nurse Practitioner	9835479-8900	UT

General Provider Information

NPI Number	:	1861677825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	APOLONIA G. SILVA FNP

Provider Business Mailing Address
First Line	:	1776 PARK AVE STE 211
Second Line	:
City	:	PARK CITY
State	:	UT
Zip	:	84060-5148
Country	:	US
Telephone Number	:	385-464-3980
Fax Number	:	385-464-3990

Provider Business Practice Location Address
First Line	:	1776 PARK AVE STE 211
Second Line	:
City	:	PARK CITY
State	:	UT
Zip	:	84060-5148
Country	:	US
Telephone Number	:	385-464-3980
Fax Number	:	385-464-3990

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2008
Last Update Date	:	06/03/2024

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