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MINDFUL HEALING LLC NPI 1346732765


NPI Information

NPI: 1346732765
Provider Name: MINDFUL HEALING LLC

Doing Business As: SOUTHWICK INTEGRATIVE HEALING

Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 46D2149796

Address:
8541 S REDWOOD RD STE C2
WEST JORDAN, UT
ZIP 84088
Phone: (801) 432-7712
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MINDFUL HEALING LLC is a family nurse practitioner in West Jordan, UT. MINDFUL HEALING LLC NPI is 1346732765. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Southwick Integrative Healing.

The provider's business location address is:

8541 S REDWOOD RD STE C2
WEST JORDAN, UT
ZIP 84088
Phone: (801) 432-7712

The provider's authorized official is Martha Southwick .
The authorized official title is Owner/employee and has the following contact phone number (801) 432-7712.

The CLIA number assigned to this NPI record is 46D2149796 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/1/2018 and was last updated on 8/17/2018.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LF0000XNurse PractitionerFamily200020-4405UTAHYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11017129MEDICAIDUTAH

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

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