Provider Demographics
NPI:1972553014
Name:SAUNDERS, HILARY FAE (APRN)
Entity type:Individual
Prefix:
First Name:HILARY
Middle Name:FAE
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:HILARY
Other - Middle Name:FAE
Other - Last Name:ISENHOUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APR,N
Mailing Address - Street 1:100 MARIO CAPECCHI DR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84113-1103
Mailing Address - Country:US
Mailing Address - Phone:801-662-5340
Mailing Address - Fax:
Practice Address - Street 1:100 MARIO CAPECCHI DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84113-1103
Practice Address - Country:US
Practice Address - Phone:801-662-5340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT190665-4405363L00000X, 363LA2200X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
64082OtherPEHP #
78951OtherUNIVERSITY HEALTH PLANS #
QM0000050898OtherALTIUS #
01906654400001OtherREGENCE BCBS OF UTAH #
MT0437905Medicaid
UTD4077Medicaid
874968OtherDMBA #
UT008011033Medicare ID - Type Unspecified
01906654400001OtherREGENCE BCBS OF UTAH #