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Individual

THOMAS MICHAEL DENHALTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN, MSN, FNP-C

Contact information

Practice address
1303 N MAIN ST, SUITE H, CEDAR CITY, UT 84721-9746
(435) 868-5570
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
8583872-4405
UT
363LF0000X
Family Nurse Practitioner
AP2158
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
86-0338466
TAX-ID
AZ
05
966195
AZ
01
P00458986
RAILROAD MEDICARE
AZ
Enumeration date
08/10/2005
Last updated
09/04/2013
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