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NPI Code Detail

MEDICARE: ALBERTO W SOUZA NP

MEDICARE: ALBERTO W SOUZA NP
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner6873612-4405UT
2363LF0000XFamily Nurse Practitioner6873612-4405UT

General Provider Information

NPI Number : 1972846384
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALBERTO W SOUZA NP
Provider Business Mailing Address
First Line : 1664 S DIXIE DR STE E102
Second Line :
City : SAINT GEORGE
State : UT
Zip : 84770-7329
Country : US
Telephone Number : 435-703-9647
Fax Number : 435-703-6003
Provider Business Practice Location Address
First Line : 1664 S DIXIE DR STE E102
Second Line :
City : SAINT GEORGE
State : UT
Zip : 84770-7329
Country : US
Telephone Number : 435-703-9647
Fax Number : 435-703-6003
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2013
Last Update Date : 11/15/2023

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