Ellis Simonsen, Sara Marie

Ellis Simonsen, Sara Marie is an individual health care provider with primary practice located at 650 Round Valley Dr , Park City UT 84060-7571. She recently has only one registered license in Other Service Providers / Midwife, which is considered as her primary health care specialty. Ellis Simonsen, Sara Marie can be contacted via phone (435) 333-1500.

Contact Information

Primary practice address
650 Round Valley Dr Park City UT 84060-7571
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Midwife 176B00000X 5037536-4402 Utah

Profile Details

NPI number 1336604610
LBN Legal business name Ellis Simonsen, Sara Marie
Credentials CNM, MSPH, PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 31st, 2019
Last updated Jan 31st, 2019 - about 7 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 1336604610 NPPES
Utah Other 5037536-4402 CNM LICENSE

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