| Kelli Kemenah Mauric, WHNP-BC, APRN | |
|
3772 N Mountainoak Dr, Eden, UT 84310 | |
| (801) 710-2825 | |
| Not Available |
| Full Name | Kelli Kemenah Mauric |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Women's Health |
| Location | 3772 N Mountainoak Dr, Eden, Utah |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245353416 | NPI | - | NPPES |
| 0827627 | Medicaid | OH | |
| 10115460-4405 | Other | UT | APRN STATE LICENSURE |
| NP-07962 | Other | OH | OHIO BOARD OF NURSING - CERTIFICATE OF AUTHORITY FOR WHNP-BC LICENSURE - OH |
| 000000356173 | Other | OH | ANTHEM B/C B/S |
| 193200000X | Other | UT | MULTI-SPECIALTY GROUP TAXONOMY BALANCE THE BRAIN PROFESSIONAL CORPORATION |
| 363LW0102X | Other | UT | NURSE PRACTITIONER - WOMENS HEALTH TAXONOMY |
| MAU1-0427-9585 | Other | OH | NATIONAL CERTIFICATION CORPORATION -USA WOMENS HEALTH NURSE PRACTITIONER WHNP-BC |
| 1073270666 | Other | UT | NPI BALANCE THE BRAIN PROFESSIONAL CORPORATION |
| 193200000X | Other | UT | PROVIDER MULTI-SPECIALTY GROUP - SECONDARY TAXONOMY BALANCE THE BRAIN PROF CORP |
| 356173 | Other | OH | BUCKEYE |
| I20180403001591 | Other | PECOS ENROLLMENT ID | |
| R04778 | Other | OH | SUMMACARE |
| 10115460-8900 | Other | UT | APRN CONTROLLED SUBSTANCE ID |
| 104279585 | Other | NATIONAL CERTIFICATION CORPORATION - WHNP-BC (BOARD CERTIFIED) | |
| APP0002758 | Other | UT | COPIC RRG VIA BAXTER & ASSOCIATES LLC CERTIFICATE OF LIABILITY INSURANCE |
| P01571485 | Other | OH | MEDICARE RR |
| RN266333 | Other | OH | NATIONAL COUNCIL OF NURSING STATE BOARDS & LICENSURE REGISTERED NURSES |
| 740142 | Other | OH | BUCKEYE MEDICAID |
| APRN.CNP.07962 | Other | OH | WHNP-BC WITH CERTIFICATE TO PRESCRIBE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LW0102X | Nurse Practitioner - Women's Health | NP-07962 (Ohio) | Secondary |
| 363LW0102X | Nurse Practitioner - Women's Health | 10115460-4405 (Utah) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Kelli Kemenah Mauric, WHNP-BC, APRN 3772 N Mountainoak Dr, Eden, UT 84310 Ph: (801) 710-2825 | Kelli Kemenah Mauric, WHNP-BC, APRN 3772 N Mountainoak Dr, Eden, UT 84310 Ph: (801) 710-2825 |
Jordan Ryann Musgrave, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4756 Creekview Dr, Eden, UT 84310 Phone: 801-529-3910 |