MS. MARY JANE CUMBERLAND (NPI# 1396715504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396715504 |
| Entity Type | Individual |
| Full Name | MS. MARY JANE CUMBERLAND |
| Other Name | MS. JANE CUMBERLAND |
| Credential | APRN |
| Practice Address |
1020 S Main St Salt Lake City UT 84101-3176 |
| Mailing Address |
22 Q St Salt Lake City UT 84103-3950 |
| Practice Telephone | 8015397000 |
| Practice Fax Number | 8015397050 |
| Mailing Telephone | 8015316872 |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2012-01-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
2177194405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
2177194405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | ICAR | Q39422 | 01 |
| UT | RCAR | 003104021 | 01 |
| UT | U006 | 107029319101 | 01 |
| UT | U003 | 942938348MJC | 01 |
| UT | U002--DESERET MUTUAL | 857364 | 01 |
| UT | U009 | 94293834884101A008 | 01 |
| Street Address |
1020 S MAIN ST |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84101-3176 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659355790 | James D. Ricciardi | Psychologist | 1020 S Main St, Salt Lake City, UT 84101-3176 | 2005-12-02 |
| 1861958506 | Pamrose Sitake | Registered Nurse | 1020 S Main St, Salt Lake City, UT 84101-3176 | 2019-02-19 |
| 1821562760 | Christopher Davis | Pharmacy Technician | 1020 S Main St, Salt Lake City, UT 84101-3176 | 2019-01-14 |
| 1346713732 | Eric Sitta | Community Health Worker | 1020 S Main St, Salt Lake City, UT 84101-3176 | 2019-01-08 |
| 1215405048 | Mackenzie Heather Blundell | Case Manager/Care Coordinator | 1020 S Main St, Salt Lake City, UT 84101-3176 | 2018-11-09 |
| 1588132724 | Natalie Jeanine Williams | Community Health Worker | 1020 S Main St, Salt Lake City, UT 84101-3176 | 2018-11-06 |
| 1609343482 | Sophia Renee Felix | Community Health Worker | 1020 S Main St, Salt Lake City, UT 84101-3176 | 2018-10-30 |
| 1437630431 | Mark J Sanchez | Behavioral Analyst | 1020 S Main St, Salt Lake City, UT 84101-3176 | 2018-08-27 |
| 1174004196 | Kristin Emily Olsen | Behavioral Analyst | 1020 S Main St, Salt Lake City, UT 84101-3176 | 2018-08-27 |
| 1912488990 | Zachary Staton Tucker | Behavioral Analyst | 1020 S Main St, Salt Lake City, UT 84101-3176 | 2018-08-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053804237 | Holly Smith | Registered Nurse | 1020 S Main Street, Salt Lake City, UT 84101 | 2018-06-12 |
| 1174999627 | Justin Williams | Social Worker | 155 W. 300 S., Salt Lake City, UT 84101 | 2015-08-19 |
| 1902291842 | Daryl Ray Ezidore | Student in an Organized Health Care Education/Training Program | 100 South 344 East, Salt Lake City, UT 84101 | 2015-03-30 |
| 1104190859 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 50 S Main St Ste 115, Salt Lake City, UT 84101 | 2012-02-28 |
| 1366713307 | Gonstead Family Chiropractic | Chiropractor | 1154 S. 300 W., Suite C, Salt Lake City, UT 84101 | 2012-01-23 |
| 1659544880 | Jeffrey Daniel | Registered Nurse | 404 South 400 West, Salt Lake City, UT 84101 | 2008-04-09 |
| 1306030580 | Christopher Dean Chapman | Chiropractor | 345 W 100 S Ste 6c, Salt Lake City, UT 84101 | 2007-08-30 |
| 1689713497 | Walter Landon Bye | Dentist | 15 West South Temple, Gateway Tower West Suite 440, Salt Lake City, UT 84101 | 2007-02-06 |
| 1154403152 | Allison Miller Gardner | Physical Therapist | 84 West 700 South, Salt Lake City, UT 84101 | 2006-10-19 |
| 1780655407 | Frederick Van Der Veur | Social Worker | 1020 South Main Street, 242, Salt Lake City, UT 84101 | 2006-01-30 |
| Find all providers in zip 84101 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114536737 | Bradley Martin | Nurse Practitioner | 31 M St Apt 110, Salt Lake City, UT 84103-3846 | 2020-07-29 |
| 1245877448 | Carla Lucile Applegate-anderson | Nurse Practitioner | 2666 South 2000 East, Suite 101, Salt Lake City, UT 84109 | 2019-12-06 |
| 1720433196 | Lillian Farris | Nurse Practitioner | 2180 E 4500 S Ste 125, Salt Lake City, UT 84117-4021 | 2016-05-04 |
| 1164816922 | Brittany Talbot | Nurse Practitioner | Salt Lake City Vamc, 500 Foothill Dr, Salt Lake City, UT 84148-0001 | 2015-03-19 |
| 1376959023 | Charleen Angell Aprn, Pllc | Nurse Practitioner | 145 S 400 E, Salt Lake City, UT 84111-2104 | 2014-07-02 |
| 1619390218 | Darin Ashton Principe | Nurse Practitioner | 159 W Broadway Ste 200, Salt Lake City, UT 84101-1923 | 2014-02-03 |
| 1083052963 | Christina Elizabeth Burton | Nurse Practitioner | 1008 S 1100 E, Apt 6, Salt Lake City, UT 84105 | 2013-06-12 |
| 1124237011 | Maria Christina Paegle | Nurse Practitioner | 4659 Brookwood Dr, Salt Lake City, UT 84117-4909 | 2007-05-21 |
| 1558430389 | Grace Forsythe Phd Inc | Nurse Practitioner | 2046 Murray Holladay Rd, 103, Salt Lake City, UT 84117-5125 | 2006-11-07 |
| 1639279466 | Joann M Rolando | Nurse Practitioner | George E Wahlen Department of Veterans Affairs, Medical Center Va, Salt Lake City, UT 84148-0001 | 2006-09-22 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84101 |
Please comment or provide details below to improve the information on MS. MARY JANE CUMBERLAND.
| 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.