KELLI KEMENAH MAURIC WHNP-BC APRN NPI 1245353416

NPI Information

NPI: 1245353416
Provider Name: KELLI KEMENAH MAURIC, WHNP-BC, APRN
Classification: Nurse Practitioner - 363LW0102X
Entity Type: Individual

Specialization: Women's Health

PECOS Registration: Yes

Address:
3772 N MOUNTAINOAK DR
EDEN, UT
ZIP 84310
Phone: (801) 710-2825
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Kelli Kemenah Mauric, WHNP-BC, APRN is a women's health nurse practitioner in Eden, UT. Kelli Kemenah Mauric, WHNP-BC, APRN NPI is 1245353416. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3772 N MOUNTAINOAK DR
EDEN, UT
ZIP 84310
Phone: (801) 710-2825

The NPI 1245353416 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/10/2007 and was last updated on 6/21/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LW0102X	Nurse Practitioner	Women's Health	NP-07962	OHIO	No
2	363LW0102X	Nurse Practitioner	Women's Health	10115460-4405	UTAH	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0827627	MEDICAID	OHIO
2	10115460-4405	OTHER	UTAH	APRN STATE LICENSURE
3	NP-07962	OTHER	OHIO	OHIO BOARD OF NURSING - CERTIFICATE OF AUTHORITY FOR WHNP-BC LICENSURE - OH
4	000000356173	OTHER	OHIO	ANTHEM B/C B/S
5	193200000X	OTHER	UTAH	MULTI-SPECIALTY GROUP TAXONOMY BALANCE THE BRAIN PROFESSIONAL CORPORATION
6	363LW0102X	OTHER	UTAH	NURSE PRACTITIONER - WOMENS HEALTH TAXONOMY
7	MAU1-0427-9585	OTHER	OHIO	NATIONAL CERTIFICATION CORPORATION -USA WOMENS HEALTH NURSE PRACTITIONER WHNP-BC
8	1073270666	OTHER	UTAH	NPI BALANCE THE BRAIN PROFESSIONAL CORPORATION
9	193200000X	OTHER	UTAH	PROVIDER MULTI-SPECIALTY GROUP - SECONDARY TAXONOMY BALANCE THE BRAIN PROF CORP
10	356173	OTHER	OHIO	BUCKEYE
11	I20180403001591	OTHER		PECOS ENROLLMENT ID
12	R04778	OTHER	OHIO	SUMMACARE
13	10115460-8900	OTHER	UTAH	APRN CONTROLLED SUBSTANCE ID
14	104279585	OTHER		NATIONAL CERTIFICATION CORPORATION - WHNP-BC (BOARD CERTIFIED)
15	APP0002758	OTHER	UTAH	COPIC RRG VIA BAXTER & ASSOCIATES LLC CERTIFICATE OF LIABILITY INSURANCE
16	P01571485	OTHER	OHIO	MEDICARE RR
17	RN266333	OTHER	OHIO	NATIONAL COUNCIL OF NURSING STATE BOARDS & LICENSURE REGISTERED NURSES
18	740142	OTHER	OHIO	BUCKEYE MEDICAID
19	APRN.CNP.07962	OTHER	OHIO	WHNP-BC WITH CERTIFICATE TO PRESCRIBE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

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