ANDREA GRAHAM SOUTHERLAND (NPI# 1932353380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932353380 |
| Entity Type | Individual |
| Full Name | ANDREA GRAHAM SOUTHERLAND |
| Credential | NP |
| Practice Address |
1420 W 12600 S Ste 102 Riverton UT 84065-7080 |
| Practice Telephone | 8012544600 |
| Practice Fax Number | 8012549670 |
| Mailing Telephone | 8012544600 |
| Mailing Fax Number | 8012549670 |
| Enumeration Date | 2008-11-12 |
| Last Update Date | 2019-06-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
4552609-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | NPI | 1932353380 | 01 |
| Street Address |
1420 W 12600 S STE 102 |
| City | RIVERTON |
| State | UT |
| Zip Code | 84065-7080 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912136862 | New Horizon Medical Care Inc | Family Medicine | 1420 W 12600 S Ste 102, Riverton, UT 84065-7080 | 2009-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659972248 | William Lance Andersen | Pharmacist | 1202 W 12600 W, Riverton, UT 84065 | 2020-11-02 |
| 1275172678 | Dentists of Riverton, LLP | Dentist | 4531 W. Partridgehill Lane, Suite F-110, Riverton, UT 84065 | 2020-01-02 |
| 1194201467 | Patrick Kunkel | Dentist | 12569 2700 W, #100, Riverton, UT 84065 | 2018-07-19 |
| 1790274546 | Harmon City Inc | Pharmacy | 13330 South Kestrel Range Road, Riverton, UT 84065 | 2018-05-08 |
| 1386147767 | Richard Hayes Johnston | Counselor | 3740 S Market Center Dr #1200, Riverton, UT 84065 | 2018-03-13 |
| 1023537156 | Brenda Fuell | Dental Hygienist | 12959 South Picket Fence Lane, Riverton, UT 84065 | 2017-09-09 |
| 1407373426 | Bethany Marie Breck | Counselor | 3740 S Market Center Drive, #1200, Riverton, UT 84065 | 2017-08-30 |
| 1952848509 | Renaissance Ranch Bluffdale Women's Program | Substance Abuse Rehabilitation Facility | 2356 Thunderhead Way, Bluffdale, UT 84065 | 2017-01-20 |
| 1053856229 | Bradford Scott Bentley Jr. | Physical Therapist | 3741 W 12600 S, Ste 100, Riverton, UT 84065 | 2016-12-27 |
| 1194273524 | New Horizon | Preferred Provider Organization | 1420 W 12600 Sputh, Draper, UT 84065 | 2016-09-14 |
| Find all providers in zip 84065 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174130629 | Jessica Noel Wagner | Nurse Practitioner | 12828 S 3600 W Ste 101, Riverton, UT 84065-6853 | 2020-09-29 |
| 1164071403 | Kirsten Nelson | Nurse Practitioner | 1420 W 12600 S, Riverton, UT 84065-7070 | 2019-09-09 |
| 1477039261 | William E Turgoose | Nurse Practitioner | 5392 W Autumn Heights Dr, Riverton, UT 84096-6571 | 2018-07-14 |
| 1679095111 | Sariah Pok Machado-lovon | Nurse Practitioner | 13348 S Market Center Dr Ste 210, Riverton, UT 84065-8011 | 2017-07-15 |
| 1841725470 | Jodi Laughlin | Nurse Practitioner | 400 Highway, Riverton, NJ 08077 | 2017-04-20 |
| 1558804641 | Erika Seaquist-goble | Nurse Practitioner | 13624 S Danaus Way, Riverton, UT 84096-8930 | 2016-11-22 |
| 1679967327 | Jessica Celeste Stevens | Nurse Practitioner | 1756 W Park Ave, Riverton, UT 84065-4701 | 2015-03-20 |
| 1003244294 | Sue E. Terry | Nurse Practitioner | 6524 Se Quakervale Rd, Riverton, KS 66770-4214 | 2013-10-24 |
| 1285252536 | Josiah Bonnell | Nurse Practitioner | 1756 W Park Ave, Riverton, UT 84065-4701 | 2020-07-13 |
| 1578107439 | Emily Sue Richards | Nurse Practitioner | 1273 W 12600 S Ste 403, Riverton, UT 84065-7111 | 2019-11-04 |
| Find all providers in RIVERTON | ||||
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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.