Individual
MS. DEBORAH MARIE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM APRN
Contact information
Practice address
1225 E FORT UNION BLVD, STE 215, COTTONWOOD HEIGHTS, UT 84047-1889
(801) 233-4200
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 233-4200
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2206804405
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
220680-4405
UT
367A00000X
Advanced Practice Midwife
2206804402
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841250602
NPI FOR LEON HANSEN
UT
Enumeration date
06/11/2007
Last updated
02/29/2016
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