| Myndfull Care Management Utah Pc | |
|
240 N East Promontory Ste C-200 Farmington UT 84025-2950 | |
| (855) 839-8878 | |
| Not Available |
| Full Name | Myndfull Care Management Utah Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 240 N East Promontory Ste C-200, Farmington, Utah |
| Authorized Official Name and Position | Teja Singh (MD) |
| Authorized Official Contact | 8558398878 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Myndfull Care Management Utah Pc 9436 W Lake Mead Blvd Suite 5 Pmb 1113 Las Vegas NV 89134 Ph: () - | Myndfull Care Management Utah Pc 240 N East Promontory Ste C-200 Farmington UT 84025-2950 Ph: (855) 839-8878 |
| NPI Number | 1649962440 |
|---|---|
| Provider Enumeration Date | 05/22/2023 |
| Last Update Date | 01/05/2024 |
| Medicare PECOS PAC ID | 8527420363 |
|---|---|
| Medicare Enrollment ID | O20230810004322 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649962440 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Secondary |
| Provider Name | Jessinna Nielson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700427382 PECOS PAC ID: 9638503568 Enrollment ID: I20191230002180 |
| Provider Name | Teja Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205875606 PECOS PAC ID: 5193732030 Enrollment ID: I20230810004370 |
| Provider Name | Sharon Kepple |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720460934 PECOS PAC ID: 0749653277 Enrollment ID: I20231017002865 |
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