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NPI 1275266009ActiveOrganization· Nurse Practitioner· Sandy, UT
Nurse Practitioner in Sandy, Utah, registered in NPPES in July 2022. The authorized official on file is Brittany Lee Bouchard, President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1275266009 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 8, 2022 |
| Last updated in NPPES | Oct 29, 2022 |
| Certified by provider | Oct 29, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (UT) |
|---|
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