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NPI Code Detail

MEDICARE: DANAE MICHELLE TITENSOR APRN

MEDICARE: DANAE MICHELLE TITENSOR 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
1208600000XSurgery Physician8281304-4405UT
2363L00000XNurse Practitioner8281304-4405UT
3207Q00000XFamily Medicine Physician8281304-4405UT

General Provider Information

NPI Number : 1902574676
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANAE MICHELLE TITENSOR APRN
Provider Business Mailing Address
First Line : 3550 N UNIVERSITY AVE STE 250
Second Line :
City : PROVO
State : UT
Zip : 84604-6695
Country : US
Telephone Number : 801-374-9625
Fax Number : 801-374-9690
Provider Business Practice Location Address
First Line : 3550 N UNIVERSITY AVE STE 250
Second Line :
City : PROVO
State : UT
Zip : 84604-6695
Country : US
Telephone Number : 801-374-9625
Fax Number : 801-374-9690
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2021
Last Update Date : 03/11/2026

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Directions to “ DANAE MICHELLE TITENSOR APRN” Practice Location

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