Mrs Lisa Ann Runyon, CPNP - Nurse Practitioner in Salt Lake City, UT

Mrs Lisa Ann Runyon, CPNP is a Nurse Practitioner - Pediatrics based in Salt Lake City, Utah. Mrs Lisa Ann Runyon is licensed to practice in Utah (license number 216679-4405) and her current practice location is 100 N Medical Dr, Trauma Services, Salt Lake City, Utah. She can be reached at her office (for appointments etc.) via phone at (801) 662-2993.

NPI number for Mrs Lisa Ann Runyon is 1003091430 and her current mailing address is 100 N Medical Dr, Trauma Services, Salt Lake City, Utah. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1003091430.

Contact Information

Mrs Lisa Ann Runyon, CPNP
100 N Medical Dr, Trauma Services,
Salt Lake City, UT 84113-1103
(801) 662-2993
(801) 662-2999

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Provider's Profile

Full NameMrs Lisa Ann Runyon
GenderFemale
SpecialityNurse Practitioner - Pediatrics
Location100 N Medical Dr, Salt Lake City, Utah
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1003091430
  • Provider Enumeration Date: 01/03/2008
  • Last Update Date: 01/03/2008

Medical Identifiers

Medical identifiers for Mrs Lisa Ann Runyon such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1003091430NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0200XNurse Practitioner - Pediatrics 216679-4405 (Utah)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Lisa Ann Runyon is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mrs Lisa Ann Runyon, CPNP
100 N Medical Dr, Trauma Services,
Salt Lake City, UT 84113-1103

Ph: (801) 662-2993
Mrs Lisa Ann Runyon, CPNP
100 N Medical Dr, Trauma Services,
Salt Lake City, UT 84113-1103

Ph: (801) 662-2993

Reviews and Comments


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