KELLI K MAURIC (NPI# 1245353416) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245353416 |
| Entity Type | Individual |
| Full Name | KELLI K MAURIC |
| Credential | NP |
| Practice Address |
1525 E 6000 S Ogden UT 84405-7144 |
| Practice Telephone | 8013375800 |
| Mailing Telephone | 8013375800 |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2017-12-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
10115460-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
NP-07962 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0827627 | 05 | |
| OH | BUCKEYE | 356173 | 01 |
| OH | BUCKEYE MEDICAID | 740142 | 01 |
| OH | MEDICARE RR | P01571485 | 01 |
| OH | MEDICAL LICENSE | NP07962 | 01 |
| OH | SUMMACARE | R04778 | 01 |
| OH | ANTHEM B/C B/S | 000000356173 | 01 |
| Street Address |
1525 E 6000 S |
| City | OGDEN |
| State | UT |
| Zip Code | 84405-7144 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134121148 | Brian Keith Brzowski | Specialist | 1525 E 6000 S, Suite C, Ogden, UT 84405-7144 | 2005-08-10 |
| 1003892480 | Wesley Boyd Davis | Obstetrics & Gynecology | 1525 E 6000 S, Ogden, UT 84405-7144 | 2005-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669028171 | Alyssa House | Behavioral Analyst | 4933 1500 West #110, Riverdale, UT 84405 | 2019-08-12 |
| 1518525989 | Petersen Farms Assisted Living & Memory Care | Assisted Living Facility | 6980 S. 475 E., South Weber, UT 84405 | 2019-05-31 |
| 1376038141 | National Vision, Inc. | Technician/Technologist | 821 West Riverdale Road, Riverdale, UT 84405 | 2018-06-25 |
| 1194218461 | South Weber City | Ambulance | 7365 S 1375 E, South Weber, UT 84405 | 2018-06-12 |
| 1528572682 | Sandra Jo Scott | Dental Hygienist | 264 W Ridgeline Dr, Washington Terrace, UT 84405 | 2017-11-28 |
| 1376079061 | Loretta Shupe | Registered Nurse | 5319 S 500 E, Ogden, UT 84405 | 2017-05-02 |
| 1134661374 | Randy Ferrin | Registered Nurse | 5697 Maplewood Drive, South Ogden, UT 84405 | 2016-11-04 |
| 1871046284 | Karla Rosen | Counselor | 5202 S. Freeway Park Dr., Riverdale, UT 84405 | 2016-08-02 |
| 1053784520 | Jenifer Rebecca Nilson Smith | Physical Therapist | 5648 S. Adams Ave, Washington Terrace, UT 84405 | 2015-11-05 |
| 1972976454 | Jenniferlyn Fletcher | Physical Therapy Assistant | 5648 South Adams Ave, Washington Terrace, UT 84405 | 2015-11-05 |
| Find all providers in zip 84405 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538635628 | Sarah Sanns | Nurse Practitioner | 1486 E Skyline Dr Ste 201, Ogden, UT 84405-4877 | 2018-10-16 |
| 1114239563 | Pegah Christine Dixon | Nurse Practitioner | 4403 Harrison Blvd, Suite 4815, Ogden, UT 84403-3271 | 2010-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225652290 | Angela M Jones | Nurse Practitioner | 7691 S Alida Dr, West Jordan, UT 84084-3889 | 2020-06-04 |
| 1275185845 | Jennifer Hewlett | Nurse Practitioner | 6775 S Meadow Downs Way, Cottonwood Heights, UT 84121-6073 | 2019-07-12 |
| 1770070260 | Eastern Utah Womens Health LLC | Nurse Practitioner | 77 S 600 E Ste B, Price, UT 84501-3174 | 2018-04-19 |
| 1720503881 | Jennifer Elaine Lazzara | Nurse Practitioner | 3592 W 9000 S Ste 210, West Jordan, UT 84088-8819 | 2017-08-10 |
| 1659726511 | Erin Johnson Cole | Nurse Practitioner | 10 S 2000 E # Slc, Salt Lake City, UT 84112-5880 | 2016-04-28 |
| 1386063048 | Vennie Ying | Nurse Practitioner | 3090 E 3300 S Ste 100, Salt Lake City, UT 84109-2106 | 2014-04-10 |
| 1194157123 | Brianna Lastre | Nurse Practitioner | 1446 W Pleasant Grove Blvd., Pleasant Grove, UT 84062 | 2013-08-01 |
| 1912339078 | Melanie J Ward | Nurse Practitioner | 5063 S Cottonwood St Ste 120, Murray, UT 84107-6772 | 2013-07-31 |
| 1902112600 | Cecily Light | Nurse Practitioner | 1167 Bryan Ave, Salt Lake City, UT 84105-2507 | 2010-08-19 |
| 1619160280 | Holly Danielle Stewart | Nurse Practitioner | 348 E 4500 S Ste 200, Salt Lake City, UT 84107-3936 | 2007-08-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.