LISA O'DONNAL


Address: 750 N Freedom Blvd, Provo, UT 84601-1677
Phone: 8013734760

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).

Provider Overview

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

Taxonomy

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

Provider Secondary Practice Location

Address Telephone Number Fax Number
4460 S Highland Dr, Salt Lake City, UT 841243543 8889494864

Office Location

Street Address 750 N FREEDOM BLVD
City PROVO
State UT
Zip Code 84601-1677

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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
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Competitor

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City PROVO
Zip Code 84601

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Dataset Information

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.

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