Vadeboncoeur, Renee A
Vadeboncoeur, Renee A is an individual health care provider with primary practice located at 50 N Medical Dr , Salt Lake City UT 84132-0001. She recently has 4 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Vadeboncoeur, Renee A can be contacted via phone (801) 581-2121.Contact Information
Primary practice address
50 N Medical Dr
Salt Lake City UT 84132-0001
Phone: (801) 581-2121
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | 223122-4405 | Utah |
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | 223122-4405 | Utah |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 223122-4405 | Utah |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 223122-4405 | Utah |
Profile Details
| NPI number | 1659320240 |
|---|---|
| LBN Legal business name | Vadeboncoeur, Renee A |
| Credentials | DNP, FNP-BC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 9th, 2006 |
| Last updated | Dec 20th, 2021 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659320240 | NPPES |
| Idaho | MEDICAID | 806407400 | |
| Idaho | MEDICAID | 29303796 | |
| Idaho | MEDICAID | 100503073 | |
| Idaho | MEDICAID | NP655UT | |
| Idaho | MEDICAID | D4591 | |
| Idaho | Other | 9461 |
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