Van Wormer, Terry Russell
Van Wormer, Terry Russell is an individual health care provider with primary practice located at 2121 N 1700 W , Layton UT 84041-8803. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Van Wormer, Terry Russell can be contacted via phone (801) 773-4840.Contact Information
Primary practice address
2121 N 1700 W
Layton UT 84041-8803
Phone: (801) 773-4840
Fax: (801) 525-8151
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X |
Profile Details
| NPI number | 1467439505 |
|---|---|
| LBN Legal business name | Van Wormer, Terry Russell |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 29th, 2005 |
| Last updated | Jul 21st, 2022 - about 2 years ago |
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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