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8706 S 700 E Ste 203 Sandy UT 84070-1809 | |
(801) 572-0443 | |
Not Available |
Full Name | |
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Speciality | Nurse Practitioner |
Location | 8706 S 700 E Ste 203, Sandy, Utah |
Authorized Official Name and Position | Whitney Miller (BILLING) |
Authorized Official Contact | 8015720443 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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8706 S 700 E Ste 203 Sandy UT 84070-1809 Ph: (801) 572-0443 | 8706 S 700 E Ste 203 Sandy UT 84070-1809 Ph: (801) 572-0443 |
NPI Number | 1598478513 |
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Provider Enumeration Date | 01/04/2023 |
Last Update Date | 01/23/2023 |
Medicare PECOS PAC ID | 5092187815 |
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Medicare Enrollment ID | O20230203001958 |
Identifier | Type | State | Issuer |
---|---|---|---|
1598478513 | NPI | - | NPPES |
196895-4405 | Other | UT | STATE LICENSE NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
Provider Name | Carrie A Chandler |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326229782 PECOS PAC ID: 4284798513 Enrollment ID: I20090130000337 |
Vernon K. Liu Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 880 E 9400 S, Suite 102, Sandy, UT 84094 Phone: 801-576-1118 Fax: 801-576-1221 | |
Utah Gastroenterology Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10150 S Petunia Way Ste B, Sandy, UT 84092 Phone: 801-619-9000 | |