Provider Demographics
NPI:1568665784
Name:SMITH-HOLMEN, BARBARA (NP)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:SMITH-HOLMEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10965 S STATE
Mailing Address - Street 2:#100
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-4270
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10965 S STATE ST
Practice Address - Street 2:#100
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-4270
Practice Address - Country:US
Practice Address - Phone:801-572-0311
Practice Address - Fax:801-571-1369
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT202786-4405163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical