STEPHANIE G MISHENKO NPI 1790396554

NPI Information

NPI: 1790396554
Provider Name: STEPHANIE G MISHENKO
Classification: Military Health Care Provider - 171000000X
Entity Type: Individual
Address:
344E 100S
SLC, UT
ZIP 84111
Phone: (801) 322-3222
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Stephanie G Mishenko is a military health care provider in Slc, UT. The provider is active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. Stephanie G Mishenko NPI is 1790396554. The provider is registered as an individual entity type and is a multi-specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

344E 100S
SLC, UT
ZIP 84111
Phone: (801) 322-3222

The enumeration date for this NPI number is 8/13/2020 and was last updated on 8/13/2020.

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	171000000X	Military Health Care Provider			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	17100000X	MEDICAID	UTAH

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

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