Provider Demographics
NPI:1285857094
Name:TOLMAN, DEANNA RAE (DNP)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:RAE
Last Name:TOLMAN
Suffix:
Gender:
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1972 W GOLDEN POND WAY
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84059-3394
Mailing Address - Country:US
Mailing Address - Phone:303-888-6081
Mailing Address - Fax:
Practice Address - Street 1:1972 W GOLDEN POND WAY
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84059-3394
Practice Address - Country:US
Practice Address - Phone:303-888-6081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO103681363LF0000X
UT11290045-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO19832508Medicaid
CO810999Medicare PIN
CO810999Medicare UPIN
CO810999Medicare Oscar/Certification