| Optimal Health Family Practice | |
|
240 E Center Street Provo UT 84606 | |
| (801) 877-5801 | |
| (801) 877-5802 |
| Full Name | Optimal Health Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 240 E Center Street, Provo, Utah |
| Authorized Official Name and Position | Connie Taylor (OWNER/NP) |
| Authorized Official Contact | 8018775801 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optimal Health Family Practice 240 E Center Street Provo UT 84606 Ph: (801) 877-5801 | Optimal Health Family Practice 240 E Center Street Provo UT 84606 Ph: (801) 877-5801 |
| NPI Number | 1275099897 |
|---|---|
| Provider Enumeration Date | 02/19/2019 |
| Last Update Date | 05/12/2023 |
| Medicare PECOS PAC ID | 0749511723 |
|---|---|
| Medicare Enrollment ID | O20191004001635 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275099897 | NPI | - | NPPES |
| 603203313 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Connie D Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013210236 PECOS PAC ID: 2466623582 Enrollment ID: I20110922000066 |
| Provider Name | Elizabeth Daniels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922376383 PECOS PAC ID: 1254596091 Enrollment ID: I20120629000364 |
| Provider Name | Alyssa Dawn Vest |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497104368 PECOS PAC ID: 7719274893 Enrollment ID: I20160919001219 |
| Provider Name | Devan M Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841713401 PECOS PAC ID: 5890040406 Enrollment ID: I20180622001960 |
| Provider Name | Julia J Knaphus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811484470 PECOS PAC ID: 4284985219 Enrollment ID: I20181001002140 |
| Provider Name | Krista Michelle Brinkerhoff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437775137 PECOS PAC ID: 8729482351 Enrollment ID: I20210804002273 |
| Provider Name | Sara Maestas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962075788 PECOS PAC ID: 2668867573 Enrollment ID: I20220311000288 |
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