Mr Craig Penton, APRN | |
822 E Main St Ste 7, Grantsville, UT 84029-2501 | |
(435) 884-3578 | |
Not Available |
Full Name | Mr Craig Penton |
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Gender | Male |
Speciality | Nurse Practitioner - Family |
Location | 822 E Main St Ste 7, Grantsville, Utah |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1780037077 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 8295780-3102 (Utah) | Secondary |
363LF0000X | Nurse Practitioner - Family | 8295780-4405 (Utah) | Primary |
Entity Name | Tooele Clinic Corp |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1073512364 PECOS PAC ID: 6800700873 Enrollment ID: O20031113000800 |
Mailing Address | Practice Location Address |
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Mr Craig Penton, APRN 89 W Hidden Acres Ln, Erda, UT 84074-5585 Ph: (435) 224-2634 | Mr Craig Penton, APRN 822 E Main St Ste 7, Grantsville, UT 84029-2501 Ph: (435) 884-3578 |
Ms. Katherine E Devries, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 225 W Apple St, Grantsville, UT 84029 Phone: 435-843-9964 Fax: 435-843-9964 | |
Pamela Sue Smith, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 564 S Saddle Rd, Grantsville, UT 84029 Phone: 435-224-3124 | |
Shaun Gundersen, DNP, APRN, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 163 S Sr 112 Hwy Ste 106, Grantsville, UT 84029 Phone: 435-264-4164 Fax: 435-264-4264 |