Bacani, Andrea Kirstin

Bacani, Andrea Kirstin is an individual health care provider with primary practice located at 4403 Harrison Blvd Ste 3650, Ogden UT 84403-3271. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Rheumatology. Allopathic & Osteopathic Physicians / Rheumatology is her primary health care specialty. Bacani, Andrea Kirstin can be contacted via phone (801) 387-7125.

Contact Information

Primary practice address
4403 Harrison Blvd Ste 3650 Ogden UT 84403-3271
Phone: (801) 387-7125
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 34524 Arizona
Allopathic & Osteopathic Physicians / Rheumatology 207RR0500X 103872 Minnesota
Allopathic & Osteopathic Physicians / Rheumatology 207RR0500X 51043 Minnesota
Allopathic & Osteopathic Physicians / Rheumatology 207RR0500X 8027519-1205 Utah

Profile Details

NPI number 1730163239
LBN Legal business name Bacani, Andrea Kirstin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2005
Last updated Aug 31st, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730163239 NPPES
Arizona MEDICAID 223832
Arizona Other P00728951
Arizona MEDICAID ENROLLED

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