BRENDA LEE WALLER (NPI# 1073125373) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073125373 |
| Entity Type | Individual |
| Full Name | BRENDA LEE WALLER |
| Practice Address |
729 N Redwood Rd Salt Lake City UT 84116-1909 |
| Mailing Address |
Po Box 16495 Salt Lake City UT 84116 |
| Practice Telephone | 8015323795 |
| Practice Fax Number | 8015324909 |
| Mailing Telephone | 8015323795 |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2020-08-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183700000X | Pharmacy Technician | 9250968-1717 | UT | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093794133 | Brenda Sue Waller | Physical Medicine & Rehabilitation | 1935 Thomson Dr, Lynchburg, VA 24501-1008 | 2006-01-16 |
| 1104233949 | Brenda Diane Waller | Registered Nurse | Hwy 160/163 Building Ka 2010, Kayenta, AZ 86033-0368 | 2014-07-14 |
| Street Address |
729 N REDWOOD RD |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84116-1909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457783201 | Pharmacare, LLC | Pharmacy | 729 N Redwood Rd, Attn Super Value Pharmacy, Salt Lake City, UT 84116-1909 | 2013-08-04 |
| 1235516600 | Albertsons LLC | Durable Medical Equipment & Medical Supplies | 729 N Redwood Rd, Salt Lake City, UT 84116-1909 | 2015-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689281818 | Devery White | Case Manager/Care Coordinator | 195 N 1900 W, Salt Lake City, UT 84116 | 2020-10-01 |
| 1114402377 | Felicia Marie Speer | Community Health Worker | 1303 Sir Phillip Dr, Salt Lake City, UT 84116 | 2018-10-03 |
| 1982144341 | Sharlena Schacht | Pharmacy Technician | 1040 North 2200 West, Salt Lake City, UT 84116 | 2017-03-06 |
| 1316300460 | Riverside Family Dental Care, Inc | Clinic/Center | 1614 W 700 N, Salt Lake City, UT 84116 | 2016-04-05 |
| 1174882856 | Marilyn Ross | Nurse Practitioner | 384 Wright Brothers Dr., Marilyn Ross Bld #2, Salt Lake City, UT 84116 | 2012-05-15 |
| 1720387137 | Lifetime Products Inc. | Durable Medical Equipment & Medical Supplies | 745 N Warm Springs Rd, Salt Lake City, UT 84116 | 2011-03-24 |
| 1811000276 | Kim Coston Christensen | Preventive Medicine | 2150 West 700 North, Kim C. Christensen D.o. Faa Sl/artcc Mfo, Salt Lake City, UT 84116 | 2006-08-17 |
| 1144705583 | Brian Larry Gashler | Family Medicine | 54 N 8th W, Salt Lake City, UT 84116 | 2018-10-02 |
| 1528350972 | Aliesha Shaw | Student in an Organized Health Care Education/Training Program | 26 South 2000 East, 5900, Salt Lake City, UT 84116 | 2011-05-04 |
| 1427035187 | Sarah Lynn Woolsey | Family Medicine | 1365 W 1000 N, Salt Lake City, UT 84116 | 2005-12-23 |
| Find all providers in zip 84116 | ||||
| Taxonomy Code | 183700000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacy Technician |
| A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. |
| Notes: Source: Pharmacy Technician Certification Board, www.ptcb.org [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245796358 | Crystal Paredes | Pharmacy Technician | 1020 S Main St Ste 110, Salt Lake City, UT 84101-3176 | 2019-02-13 |
| 1982144341 | Sharlena Schacht | Pharmacy Technician | 1040 North 2200 West, Salt Lake City, UT 84116 | 2017-03-06 |
| 1588724397 | Jolley's Corner Variety, Inc. | Pharmacy Technician | 1676 E 1300 S, Salt Lake City, UT 84105-1704 | 2006-12-11 |
| 1265546584 | Jason Allen Dunn | Pharmacy Technician | 1260 E Vine St, Salt Lake City, UT 84121 | 2006-08-17 |
| 1700487048 | Michelle Teresa Wilcock | Pharmacy Technician | 4460 S Highland Dr Ste 210, Salt Lake City, UT 84124-3550 | 2020-11-03 |
| 1023621232 | Thomas Alan Good Lance White Bull | Pharmacy Technician | 500 Foothill Dr, Salt Lake City, UT 84148-0001 | 2020-08-26 |
| 1134738792 | Bailee Marie Anderson | Pharmacy Technician | 4460 S Highland Dr Ste 210, Salt Lake City, UT 84124-3550 | 2020-07-29 |
| 1538788013 | Andrew Ronald Johnson | Pharmacy Technician | 500 Foothill Dr, Salt Lake City, UT 84148-0001 | 2020-04-14 |
| 1821562760 | Christopher Davis | Pharmacy Technician | 1020 S Main St, Salt Lake City, UT 84101-3176 | 2019-01-14 |
| 1730660622 | Aubrey Nielsen | Pharmacy Technician | 4460 S Highland Dr, Salt Lake City, UT 84124-3543 | 2018-08-28 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84116 |
Please comment or provide details below to improve the information on BRENDA LEE WALLER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.