BLUE SAGE MEDICAL LLC NPI 1487016226

NPI Information

NPI: 1487016226
Provider Name: BLUE SAGE MEDICAL LLC
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
6300 SAGEWOOD DR
SUITE H-532
PARK CITY, UT
ZIP 84098
Phone: (801) 718-7280
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BLUE SAGE MEDICAL LLC is a primary care nurse practitioner in Park City, UT. BLUE SAGE MEDICAL LLC NPI is 1487016226. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

6300 SAGEWOOD DR
SUITE H-532
PARK CITY, UT
ZIP 84098-502
Phone: (801) 718-7280
Fax: (888) 853-5162

The provider's authorized official is Gina Coccimiglio .
The authorized official title is Agpcnp and has the following contact phone number (801) 718-7280.

The enumeration date for this NPI number is 3/22/2016 and was last updated on 8/29/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP2300X	Nurse Practitioner	Primary Care	123071-4405	UTAH	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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