DEBRA WILLARDSON (NPI# 1467513713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467513713 |
| Entity Type | Individual |
| Full Name | DEBRA WILLARDSON |
| Credential | ATC |
| Practice Address |
1825 E South Campus Dr Athletics Dept. Salt Lake City UT 84112-0900 |
| Mailing Address |
1825 E South Campus Dr Atheltics Dept. Slc UT 84112-0900 |
| Practice Telephone | 8015814836 |
| Practice Fax Number | 8015855005 |
| Mailing Telephone | 8015814836 |
| Mailing Fax Number | 8015855005 |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246Z00000X | Specialist/Technologist, Other | 1216584810 | UT | Technologists, Technicians & Other Technical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | ATHLETIC TRAINER | 2255A2300X | 01 |
| Street Address |
1825 E SOUTH CAMPUS DR ATHLETICS DEPT. |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84112-0900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720054794 | Tom T. Iriye | Specialist/Technologist | 1825 E South Campus Dr, Salt Lake City, UT 84112-0900 | 2006-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508484023 | Courtney Hook | Student in an Organized Health Care Education/Training Program | 1860 E 250 S Hper East, Room 208, Salt Lake City, UT 84112 | 2020-07-10 |
| 1235792839 | Dylan Lamb | Rehabilitation Practitioner | 1850 S. 260 E, Salt Lake City, UT 84112 | 2019-04-18 |
| 1740787407 | David Bradley Patch | Student in an Organized Health Care Education/Training Program | University of Utah Hospital Dental Clinic #7, 50 N. Medical Dr., Salt Lake City, UT 84112 | 2018-04-10 |
| 1962949586 | Gina Whitehead | Nurse Practitioner | 10 South 2000 East, Salt Lake City, UT 84112 | 2017-01-20 |
| 1316493117 | Dana Friske | Specialist/Technologist | 290 S 1850 E, Room 103, Salt Lake City, UT 84112 | 2016-08-31 |
| 1548612435 | Frances Millett Johnson | Nurse Practitioner | 555 South Foothill Blvd, Suite 301, Salt Lake City, UT 84112 | 2016-07-05 |
| 1679920904 | Jason Lippman | Family Medicine | 555 S. Foothill Blvd., Ste. 301, Salt Lake City, UT 84112 | 2016-05-17 |
| 1447604335 | Joseph Mcbeth | Specialist/Technologist | 580 S. Guardsman Way, Salt Lake City, UT 84112 | 2016-04-18 |
| 1104213636 | Cameron Critchfield | Student in an Organized Health Care Education/Training Program | 26 South 2000 East, Suite 5900, Salt Lake City, UT 84112 | 2015-04-22 |
| 1942697933 | Jennifer Rose | Dentist | 50 N Medical Dr, University Hospital, Salt Lake City, UT 84112 | 2015-04-17 |
| Find all providers in zip 84112 | ||||
| Taxonomy Code | 246Z00000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| General classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912426750 | Brandon C Burton | Specialist/Technologist, Other | Cta Community Supports 4444 S, 700 E Suite 203, Salt Lake City, UT 84107 | 2017-09-13 |
| 1366805020 | Adam Ward | Specialist/Technologist, Other | 455 N 400 E, Salt Lake City, UT 84103-1230 | 2016-03-31 |
| 1659669919 | Innovasis Neurological, Inc | Specialist/Technologist, Other | 614 E 3900 S, Salt Lake City, UT 84107-1902 | 2011-07-20 |
| 1487294674 | Max Strasburger | Specialist/Technologist, Other | 4444 S 700 E Ste 203, Salt Lake City, UT 84107-3075 | 2020-01-15 |
| 1477193662 | Aileen Casas | Specialist/Technologist, Other | 4444 S 700 E Ste 203, Salt Lake City, UT 84107-3075 | 2020-01-15 |
| 1518507706 | Ryan Leister | Specialist/Technologist, Other | 4444 S 700 E Ste 203, Salt Lake City, UT 84107 | 2020-01-15 |
| 1780224972 | Jake Beede | Specialist/Technologist, Other | 4444 S 700 E Ste 203, Salt Lake City, UT 84107-3075 | 2020-01-15 |
| 1881240471 | Christine Casper | Specialist/Technologist, Other | 4444 S 700 E Ste 203, Salt Lake City, UT 84107-3075 | 2019-08-10 |
| 1619522232 | Rylee Bunten | Specialist/Technologist, Other | 4444 S 700 E Ste 203, Salt Lake City, UT 84107-3075 | 2019-08-09 |
| 1295209989 | Matthew Scott Meldrum | Specialist/Technologist, Other | 4444 S 700 E Ste 203, Salt Lake City, UT 84107-3075 | 2019-01-15 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84112 |
Please comment or provide details below to improve the information on DEBRA WILLARDSON.
| 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.