Provider Demographics
NPI:1568283067
Name:WILMARTH, MEGAN (RN)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:WILMARTH
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 1:1622 E 560 S
Mailing Address - Street 2:
Mailing Address - City:HEBER CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84032-3300
Mailing Address - Country:US
Mailing Address - Phone:805-630-7371
Mailing Address - Fax:
Practice Address - Street 1:1622 E 560 S
Practice Address - Street 2:
Practice Address - City:HEBER CITY
Practice Address - State:UT
Practice Address - Zip Code:84032-3300
Practice Address - Country:US
Practice Address - Phone:805-630-7371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10840037-3102163WC0200X, 163WL0100X, 163WN0002X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care