| Chiara Wallace, | |
|
961 E Crandall Ave, Salt Lake City, UT 84106-2107 | |
| (612) 770-9037 | |
| Not Available |
| Full Name | Chiara Wallace |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 3 Years |
| Location | 961 E Crandall Ave, Salt Lake City, Utah |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073243481 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 11624749-4405 (Utah) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (NU) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| University Of Utah Hospital And Clinics | Salt lake city, UT | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| University Of Utah Community Physicians Group | 9739403569 | 277 |
| Entity Name | University of Utah Community Physicians Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467241554 PECOS PAC ID: 9739403569 Enrollment ID: O20150126002118 |
| Mailing Address | Practice Location Address |
|---|---|
| Chiara Wallace, 961 E Crandall Ave, Salt Lake City, UT 84106-2107 Ph: (612) 770-9037 | Chiara Wallace, 961 E Crandall Ave, Salt Lake City, UT 84106-2107 Ph: (612) 770-9037 |
Mrs. Lisa Ann Runyon, CPNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 100 N Medical Dr, Trauma Services, Salt Lake City, UT 84113 Phone: 801-662-2993 Fax: 801-662-2999 |
Madeline Ann Thayer, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 100 N Mario Capecchi Dr, Salt Lake City, UT 84113 Phone: 801-662-3600 |
Ms. Eliza Dansie Parkin, RN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2218 S Dallin St, Salt Lake City, UT 84109 Phone: 801-673-7088 |
Crystal Marshall, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4460 S Highland Dr, Salt Lake City, UT 84124 Phone: 888-949-4864 |
Emma Fong, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3802 S 700 E, Salt Lake City, UT 84106 Phone: 801-264-6000 |
Ashlee Brynn Fenton, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1160 E 3900 S Ste G200, Salt Lake City, UT 84124 Phone: 801-268-7766 |
Ms. Sharon A Korhel, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1105 W 1000 N, Salt Lake City, UT 84116 Phone: 801-408-8626 Fax: 801-364-2436 |