Provider Demographics
NPI:1154166445
Name:SMOOT, TARREN (RN)
Entity type:Individual
Prefix:
First Name:TARREN
Middle Name:
Last Name:SMOOT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3875 STADIUM WAY DEPT 3901
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84408-3901
Mailing Address - Country:US
Mailing Address - Phone:801-645-8145
Mailing Address - Fax:
Practice Address - Street 1:3875 STADIUM WAY DEPT 3901
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84408-3901
Practice Address - Country:US
Practice Address - Phone:801-645-8145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program