Doctor Name: | MEGAN BLISS |
NPI Number: | 1013335215 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 6985371-4405 |
Business Practice Address: | 3354 W 7800 S West Jordan, UT - 840884506 |
Business Phone Number: | 8012822677 |
Business Fax Number: | |
Mailing Address: | 3354 W 7800 S, WEST JORDAN |
State: | UT |
Postal Code: | 840884506 |
Phone Number: | 8012822677 |
Fax Number: | |
NPI Enumeration Date: | 04/03/2014 |
NPI Last Update Date: | 04/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP2300X |
License Number: | 6985371-4405 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |