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NPI Code Detail

MEDICARE: THOMAS MICHAEL DENHALTER RN, MSN, FNP-C

MEDICARE: THOMAS MICHAEL DENHALTER RN, MSN, FNP-C
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 PractitionerAP2158AZ
2363L00000XNurse Practitioner8583872-4405UT

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00458986OTHERAZRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
186-0338466OTHERAZTAX-ID
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871594002
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS MICHAEL DENHALTER RN, MSN, FNP-C
Provider Business Mailing Address
First Line : PO BOX 27128
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84127-0128
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1303 N MAIN ST
Second Line : SUITE H
City : CEDAR CITY
State : UT
Zip : 84721-9746
Country : US
Telephone Number : 435-868-5570
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2005
Last Update Date : 09/04/2013

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