STEPHANIE G MISHENKO (NPI# 1790396554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790396554 |
Entity Type | Individual |
Full Name | STEPHANIE G MISHENKO |
Practice Address |
344e 100s Slc UT 84111 |
Practice Telephone | 8013223222 |
Mailing Telephone | 8013223222 |
Enumeration Date | 2020-08-13 |
Last Update Date | 2020-08-13 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 171000000X | Military Health Care Provider | UT | Other Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
UT | 17100000X | 05 |
Street Address |
344E 100S |
City | SLC |
State | UT |
Zip Code | 84111 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316551336 | Mary Ann Rush | Case Manager/Care Coordinator | 334 E. 100 S., Slc, UT 84111 | 2020-09-08 |
1386264802 | Mckensee M Carter | Case Manager/Care Coordinator | 334 E 100 S, Salt Lake City, UT 84111 | 2020-04-24 |
1316421761 | Community Health Centers, Inc. | Social Worker | 610 S 200 E Ste #b, Salt Lake City, UT 84111 | 2018-09-21 |
1528545506 | Lauren Brittney Harman | Case Manager/Care Coordinator | 344 E. 100 S., Salt Lake City, UT 84111 | 2018-07-23 |
1851896484 | Shivani Chowdhary | Dentist | 370 E South Temple Ste 350, Salt Lake City, UT 84111 | 2018-03-26 |
1801390661 | Jaylee Marie Watman | Case Manager/Care Coordinator | 344 E. 100 S. Ste 301, Salt Lake City, UT 84111 | 2018-03-19 |
1467963918 | Victoira Julia Graham | Case Management | 344 East 100 South Ste 301, Salt Lake City, UT 84111 | 2017-10-23 |
1750805404 | Kayla Hymas | Behavioral Analyst | 243 E. 400 S., Slc, UT 84111 | 2017-08-02 |
1134643224 | Julie Peaslee | Counselor | 275 E South Temple Ste 110, Salt Lake City, UT 84111 | 2017-07-31 |
1891236378 | Kayla Budge | Behavior Technician | 243e 400s #300, Salt Lake City, UT 84111 | 2017-03-16 |
Find all providers in zip 84111 |
Taxonomy Code | 171000000X |
Grouping | Other Service Providers |
Classification | Military Health Care Provider |
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
Notes: [7/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679174346 | Cordalynn Fell | Military Health Care Provider | 4431 S Honeywood Ln, West Valley City, UT 84120-5845 | 2020-11-07 |
1811151145 | Aaron A See | Military Health Care Provider | 793 E Grand Cayman Dr, Salt Lake City, UT 84107-3600 | 2008-07-16 |
1497362677 | Chelsey L Anderson | Military Health Care Provider | 344 E 100 S, Salt Lake City, UT 84111-1700 | 2020-09-30 |
Please comment or provide details below to improve the information on STEPHANIE G MISHENKO.
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.