Micah Taniel Stansfield-duvall (NPI# 1730465873, PAC ID# 6709045479) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1730465873 |
| PAC ID by PECOS | 6709045479 |
| Professional Enrollment ID | I20120809000308 |
| Full Name | Micah Taniel Stansfield-duvall |
| Organization Legal Name | BLUEROCK NEUROLOGICAL LLC |
| Address |
3152 N University Ave Suite 220 Provo UT 84604-4746 |
| Phone Number | 8012291014 |
| Gender | F |
| Graduation Year | 2011 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 5698070332 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 3152 N University Ave, Suite 220, Provo, UT 84604-4746 | 8012291014 | BLUEROCK NEUROLOGICAL LLC |
| 3152 N University Ave, Provo, UT 84604-4746 | 8012291014 | BLUEROCK NEUROLOGICAL LLC |
| Organization Legal Name | BLUEROCK NEUROLOGICAL LLC |
| Physicians | 1 |
| Street Address |
3152 N UNIVERSITY AVE SUITE 220 |
| City | PROVO |
| State | UT |
| Zip | 84604-4746 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Wendell A Gibby | Diagnostic Radiology | Alpharad Inc | 3152 N University Ave, Suite 100, Provo, UT 84604-4729 |
| Joseph R Watkins | Neurology | Riverside Medical Center LLC | 3152 N University Ave, Suite 120, Provo, UT 84604-4746 |
| Conrad C Gibby | Interventional Radiology | Alpharad Inc | 3152 N University Ave, Suite 100, Provo, UT 84604-4729 |
| Matthew R Poulsen | Orthopedic Surgery | Riverside Medical Center LLC | 3152 N University Ave, Suite 120, Provo, UT 84604-4746 |
| Wendell A Gibby | Diagnostic Radiology | 3152 N University Ave, Suite 100, Provo, UT 84604-4729 | |
| George M Baker | Physician Assistant | Riverside Medical Center LLC | 3152 N University Ave, Suite 120, Provo, UT 84604-4746 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nathan T Rich | Medical Oncology | Utah Cancer Specialists PC | 395 W Bulldog Blvd, Suite 103, Provo, UT 84604 |
| James G Theurer | Ophthalmology | Central Utah Eye Associates | 1735 N State St, Provo, UT 84604-1010 |
| Todd B Engen | Ophthalmology | 1735 N State St, Suite 201, Provo, UT 84604-1010 | |
| Dell C Morris | Optometry | Central Utah Eye Associates | 1735 N State St, Provo, UT 84604-1010 |
| William S Lohner | Ophthalmology | Central Utah Eye Associates | 1735 N State St, Provo, UT 84604-1010 |
| Jared T Clegg | Podiatry | Utah Podiatry Group, P.C. | 1973 N State St, Provo, UT 84604-1012 |
| Stephanie Wilson | Physician Assistant | Shelly Savage Md, LLC | 1900 N State St, Provo, UT 84604-1305 |
| Shelly L Savage | Family Medicine | Shelly Savage Md, LLC | 1900 N State St, Provo, UT 84604-1305 |
| Natalie K Thompson | Nurse Practitioner | Shelly Savage Md, LLC | 1900 N State St, Provo, UT 84604-1305 |
| Shelley Day | Nurse Practitioner | Aaron Robinson Do Pllc | 1900 N State St, Provo, UT 84604-1305 |
| Find all physicians in zip 84604 | |||
| City | PROVO |
| Zip Code | 84604 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | PROVO + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Micah Taniel Stansfield-duvall.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.