WILLIAM JOHN SELF


Address: 6222 S Moffat Farm Ln, Salt Lake City, UT 84121-6713
Phone: 9705903773

WILLIAM JOHN SELF (NPI# 1346721891) 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) 1346721891
Entity Type Individual
Full Name WILLIAM JOHN SELF
Credential FNP-C
Practice Address 6222 S Moffat Farm Ln
Salt Lake City
UT 84121-6713
Practice Telephone 9705903773
Mailing Telephone 9705903776
Mailing Fax Number 8012902466
Enumeration Date 2018-08-23
Last Update Date 2019-01-22
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163WG0000X Registered Nurse
Specialization: General Practice
9475918-3102 UT Nursing Service Providers
Y 363LF0000X Nurse Practitioner
Specialization: Family
9475918-4405 UT Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
1840 S 1300 E, Salt Lake City, UT 841053617 8014847651
1950 E 7000 S, Salt Lake City, UT 841216894 8019433300 8019433461
941 E 3300 S, Millcreek, UT 841062100 8012663700

Other Providers WILLIAM SELF

NPI Name Taxonomy Address Enumeration
1245503093 William Self Nurse Anesthetist, Certified Registered 495 S Nova Rd Ste 101a, Ormond Beach, FL 32174-8444 2012-02-09
1710984380 William Grady Self Jr. Ophthalmology 8403 Bryant St, Westminster, CO 80031-3809 2005-06-28

Office Location

Street Address 6222 S MOFFAT FARM LN
City SALT LAKE CITY
State UT
Zip Code 84121-6713

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1407483522 Kaitlyn Horne Behavior Technician 6910 S. Highland Drive, Cottonwood Heights, UT 84121 2020-03-26
1952936387 Jared Wells Behavior Technician 6910 S Highland Drive, Cottonwood Heights, UT 84121 2020-03-05
1518591874 Slc Plastic Surgery LLC Plastic Surgery 6686 Highland Drive, Cottonwood Heights, UT 84121 2020-02-26
1093273708 Anna O'hearon Counselor New Roads Behavioral Health, 2450 Fort Union Blvd, Cottonwood Heights, UT 84121 2019-03-12
1053883181 Charles Keller IIi Pediatrics 2198 S Yvonne Rd #344, Salt Lake City, UT 84121 2018-12-31
1669964516 Marissa King Specialist 1141 E. 3900 S. Suite 150a, Salt Lake, UT 84121 2018-06-05
1376044313 Slpd Cottonwood LLC Dentist 7167 South Highland Drive, 200, Cottonwood Heights, UT 84121 2018-02-26
1700315462 Nelson & Tillmann Family Dentistry, PC Dentist 5872 S. 900 E. Ste 202, Salt Lake City, UT 84121 2017-06-07
1912430588 Wasatch Midwifery and Wellness, LLC Dietitian, Registered 6440 S Wasatch Blvd, Ste 140, Holladay, UT 84121 2017-04-10
1407308331 Tina Polgar Registered Nurse 6244 Highland Drive, Murray, UT 84121 2016-10-26
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1982204590 Gabrielle Sleater Lewis Nurse Practitioner 2905 S Mcclelland St, Salt Lake City, UT 84106-2125 2020-11-01
1962019596 Freya Kristen Landesman Nurse Practitioner 60 E South Temple Ste 300, Salt Lake City, UT 84111-1041 2020-09-28
1568075604 Michelle L Davis Nurse Practitioner 24 S 1100 E Ste 305, Salt Lake City, UT 84102-4500 2020-08-28
1518583988 Melanie Elise Harris Nurse Practitioner 1250 E 3900 S Ste 301, Salt Lake City, UT 84124-1350 2020-06-22
1295359651 Julie Nielsen Nurse Practitioner 1170 E Westminster Ave Apt C, Salt Lake City, UT 84105-3514 2020-06-02
1770112138 Justin Henderson Nurse Practitioner 3851 S Birch Dr, Salt Lake City, UT 84109-3742 2020-04-07
1346885845 Anita Hui Lucente Nurse Practitioner 1111 E Brickyard Rd, Salt Lake City, UT 84106-2560 2019-11-08
1841844057 Mayra Ibeth Vences Nurse Practitioner 1146 N Antilles Dr, Salt Lake City, UT 84116-4656 2019-07-25
1710549928 Jenny Farley Mason Nurse Practitioner 4179 S Monarch Way, Salt Lake City, UT 84124-3168 2019-07-08
1144889940 Amy Jackson Gilbert Nurse Practitioner 1950 Circle of Hope Dr Rm 4146, Salt Lake City, UT 84112-5500 2019-06-06
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Competitor

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City SALT LAKE CITY
Zip Code 84121

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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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