Tanner, Mandi Lou

Tanner, Mandi Lou is an sole proprietor health care provider with primary practice located at 2512 W 2725 N , Farr West UT 84404-9469. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Tanner, Mandi Lou can be contacted via phone (801) 309-6285.

Contact Information

Primary practice address
2512 W 2725 N Farr West UT 84404-9469
Phone: (801) 309-6285
Fax: (801) 820-0401
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 4807317-4405 Utah

Profile Details

NPI number 1598434953
LBN Legal business name Tanner, Mandi Lou
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 9th, 2021
Last updated Apr 15th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598434953 NPPES
Utah Other 260022408 RAILROAD MEDICARE
Utah Other 4807317-4405 RAILROAD MEDICARE
Utah Other 000055266 RAILROAD MEDICARE
Utah MEDICAID 8760003008007 RAILROAD MEDICARE
Utah Other 4807317-8900 RAILROAD MEDICARE

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