LISA O'DONNAL (NPI# 1124584867) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124584867 |
| Entity Type | Individual |
| Full Name | LISA O'DONNAL |
| Credential | APRN |
| Practice Address |
750 N Freedom Blvd Provo UT 84601-1677 |
| Practice Telephone | 8013734760 |
| Practice Fax Number | 8013730639 |
| Mailing Telephone | 8889494864 |
| Enumeration Date | 2019-02-19 |
| Last Update Date | 2020-07-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
364770-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4460 S Highland Dr, Salt Lake City, UT 841243543 | 8889494864 |
| Street Address |
750 N FREEDOM BLVD |
| City | PROVO |
| State | UT |
| Zip Code | 84601-1677 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679551634 | Amy Buehler | Social Worker | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2006-01-09 |
| 1437750270 | Michael Stevenson | Case Manager/Care Coordinator | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2020-11-06 |
| 1174122683 | Alyssa Ketler | Case Manager/Care Coordinator | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2020-10-26 |
| 1770183261 | Kaitlin Buckway | Case Manager/Care Coordinator | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2020-10-26 |
| 1841899465 | Linda Madsen Fifita | Student in an Organized Health Care Education/Training Program | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2020-10-23 |
| 1427657352 | Jessica Ray Clyde | Licensed Practical Nurse | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2020-10-21 |
| 1134728033 | Tyra Tsosie | Student in an Organized Health Care Education/Training Program | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2020-10-21 |
| 1457950529 | Justin Jacobson | Student in an Organized Health Care Education/Training Program | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2020-10-20 |
| 1881293264 | Kurt Louis Candalot | Case Manager/Care Coordinator | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2020-10-18 |
| 1265030613 | Ailaina Nicole Herman Rice | Student in an Organized Health Care Education/Training Program | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2020-10-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902378417 | 1 Assist Care of Utah Valley LLC | In Home Supportive Care | 180 N University Avenue, Suite 270, Office 213, Provo, UT 84601 | 2018-12-21 |
| 1346723319 | Mp Dental LLC | Dentist | 777 N. 500 W. #204, Proud, UT 84601 | 2018-09-14 |
| 1326530601 | Madison Paige Nelson | Case Manager/Care Coordinator | 750 N Freedom Blvd., Provo, UT 84601 | 2018-06-03 |
| 1245758861 | Annette Roylance | Case Manager/Care Coordinator | 750 North Freedom Boulevard, Suite 300, Provo, UT 84601 | 2017-09-04 |
| 1912422205 | Alexandra Mcbride | Specialist/Technologist | 35 N 300 W #440, Provo, UT 84601 | 2017-08-07 |
| 1932638293 | Audrey Clara Clifton | Case Manager/Care Coordinator | 750 North Freedom Blvd., Provo, UT 84601 | 2017-06-08 |
| 1528514197 | Joseph Hyrum Lewis | Case Manager/Care Coordinator | 750 Freedom Blvd, Provo, UT 84601 | 2016-09-01 |
| 1629427620 | Walker Clements | Case Manager/Care Coordinator | 750 North Freedom Blvd, Provo, UT 84601 | 2016-06-09 |
| 1447611595 | Robert Shirley | Student in an Organized Health Care Education/Training Program | 750 North 200 West, Provo, Ut 84601., Provo, UT 84601 | 2016-03-17 |
| 1700286283 | Brelynn Downs | Student in an Organized Health Care Education/Training Program | 750 North Freedom Blvde, Provo, UT 84601 | 2014-09-03 |
| Find all providers in zip 84601 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700963295 | Michelle Marie Mcnew | Nurse Practitioner | 750 N 200 W Ste 300, Provo, UT 84601-1690 | 2006-11-01 |
| 1588217723 | Erin Ellsworth Falor | Nurse Practitioner | 395 W Bulldog Blvd Ste 601, Provo, UT 84604-3331 | 2019-07-17 |
| 1588150304 | Christopher Bickmore Parson | Nurse Practitioner | 395 W Bulldog Blvd, Provo, UT 84604-3311 | 2018-07-04 |
| 1518484005 | Chaz Derrick Colton | Nurse Practitioner | 1034 N 500 W, Provo, UT 84604-3380 | 2017-08-24 |
| 1538698550 | Kelsie Balmforth | Nurse Practitioner | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2017-06-05 |
| 1609223726 | Younchan Lee | Nurse Practitioner | 750 N Freedom Blvd, Provo, UT 84601 | 2016-05-18 |
| 1972986057 | Steven Faux | Nurse Practitioner | 1157 N 300 W, Suite 303, Provo, UT 84604-6124 | 2015-07-07 |
| 1669814505 | Brandon Thatcher | Nurse Practitioner | 1750 N Wymount Terrace Dr, Provo, UT 84602-7600 | 2013-07-19 |
| 1598993040 | Erin Marie Haggerty | Nurse Practitioner | 619 N 500 W, Provo, UT 84601-1547 | 2009-06-23 |
| 1114153137 | Travis J Hunter | Nurse Practitioner | 750 N Freedom Blvd, Provo, UT 84601-1677 | 2009-06-04 |
| Find all providers in PROVO | ||||
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| 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.