| Neural Effects | |
|
320 River Park Dr Ste 255 Provo UT 84604-6065 | |
| (801) 616-3675 | |
| (385) 225-9313 |
| Full Name | Neural Effects |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 320 River Park Dr Ste 255, Provo, Utah |
| Authorized Official Name and Position | Jefferson B Gaufin (CEO) |
| Authorized Official Contact | 8016163675 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neural Effects 320 River Park Dr Ste 255 Provo UT 84604-6065 Ph: (801) 616-3675 | Neural Effects 320 River Park Dr Ste 255 Provo UT 84604-6065 Ph: (801) 616-3675 |
| NPI Number | 1194330118 |
|---|---|
| Provider Enumeration Date | 09/15/2020 |
| Last Update Date | 04/25/2024 |
| Medicare PECOS PAC ID | 3072927094 |
|---|---|
| Medicare Enrollment ID | O20210202001380 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194330118 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
| Provider Name | Lynn M Gaufin |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1205857158 PECOS PAC ID: 8820010382 Enrollment ID: I20051227000332 |
| Provider Name | Thomas James Tervort |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801382593 PECOS PAC ID: 8820322746 Enrollment ID: I20190627000134 |
| Provider Name | Elizabeth Huntsman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356120455 PECOS PAC ID: 8022453885 Enrollment ID: I20240301003767 |
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