Mountain West Wound Care Inc | |
1231 N 1300 W Ste A, Centerville, UT 84014-1883 | |
(801) 815-6500 | |
Not Available |
Full Name | Mountain West Wound Care Inc |
---|---|
Type | Facility |
Speciality | Nurse Practitioner |
Location | 1231 N 1300 W Ste A, Centerville, Utah |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1083438626 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | (* (Not Available)) | Secondary |
363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
Provider Name | Melanie Muma |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104370451 PECOS PAC ID: 4587922257 Enrollment ID: I20171229002081 |
Provider Name | Nathan Payne |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1760845473 PECOS PAC ID: 5193018976 Enrollment ID: I20230131002643 |
Provider Name | Maryanne Frances Hunt |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497534002 PECOS PAC ID: 9537603378 Enrollment ID: I20240703001146 |
Provider Name | Bryan Williams |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1508215179 PECOS PAC ID: 1456688936 Enrollment ID: I20241123000399 |
Provider Name | Franklin Nebeker |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1760748487 PECOS PAC ID: 3678704095 Enrollment ID: I20241125001969 |
Mailing Address | Practice Location Address |
---|---|
Mountain West Wound Care Inc Po Box 607, Centerville, UT 84014-0607 Ph: (801) 815-6500 | Mountain West Wound Care Inc 1231 N 1300 W Ste A, Centerville, UT 84014-1883 Ph: (801) 815-6500 |